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Volume 12
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10.3390/diagnostics12051024
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Article

Endometriosis and Impaired Placentation: A Prospective Cohort Study Comparing Uterine Arteries Doppler Pulsatility Index in Pregnancies of Patients with and without Moderate-Severe Disease

by
Noemi Salmeri
1,
Antonio Farina
2,
Massimo Candiani
1,
Carolina Dolci
1,
Giulia Bonavina
1,
Caterina Poziello
1,
Paola Viganò
3 and
Paolo Ivo Cavoretto
1,*
1
Gynecology/Obstetrics Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
2
Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery (DIMEC), IRCCS Sant’Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy
3
Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
*
Author to whom correspondence should be addressed.
Diagnostics 2022, 12(5), 1024; https://doi.org/10.3390/diagnostics12051024
Submission received: 3 March 2022 / Revised: 8 April 2022 / Accepted: 16 April 2022 / Published: 19 April 2022
(This article belongs to the Special Issue Maternal-Fetal Medicine)
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Abstract

The aim of this study was to evaluate if moderate-severe endometriosis impairs uterine arteries pulsatility index (UtA-PI) during pregnancy when compared to unaffected controls. In this prospective cohort study, pregnant women with stage III–IV endometriosis according to the revised American Fertility Society (r-AFS) classification were matched for body mass index and parity in a 1:2 ratio with unaffected controls. UtA-PIs were assessed at 11–14, 19–22 and 26–34 weeks of gestation following major reference guidelines. A General Linear Model (GLM) was implemented to evaluate the association between endometriosis and UtA-PI Z-scores. Significantly higher third trimester UtA-PI Z-scores were observed in patients with r-AFS stage III–IV endometriosis when compared to controls (p = 0.024). In the GLM, endometriosis (p = 0.026) and maternal age (p = 0.007) were associated with increased third trimester UtA-PI Z-scores, whereas conception by in-vitro fertilization with frozen-thawed embryo transfer significantly decreased UtA-PI measures (p = 0.011). According to these results, r-AFS stage III–IV endometriosis is associated with a clinically measurable impaired late placental perfusion. Closer follow-up may be recommended in pregnant patients affected by moderate-severe endometriosis in order to attempt prediction and prevention of adverse pregnancy and perinatal outcomes due to a defective late placental perfusion.
Keywords: endometriosis; US; placenta; pregnancy; obstetrics; maternal diseases; Doppler; uterine arteries; UtA-PI endometriosis; US; placenta; pregnancy; obstetrics; maternal diseases; Doppler; uterine arteries; UtA-PI

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MDPI and ACS Style

Salmeri, N.; Farina, A.; Candiani, M.; Dolci, C.; Bonavina, G.; Poziello, C.; Viganò, P.; Cavoretto, P.I. Endometriosis and Impaired Placentation: A Prospective Cohort Study Comparing Uterine Arteries Doppler Pulsatility Index in Pregnancies of Patients with and without Moderate-Severe Disease. Diagnostics 2022, 12, 1024. https://doi.org/10.3390/diagnostics12051024

AMA Style

Salmeri N, Farina A, Candiani M, Dolci C, Bonavina G, Poziello C, Viganò P, Cavoretto PI. Endometriosis and Impaired Placentation: A Prospective Cohort Study Comparing Uterine Arteries Doppler Pulsatility Index in Pregnancies of Patients with and without Moderate-Severe Disease. Diagnostics. 2022; 12(5):1024. https://doi.org/10.3390/diagnostics12051024

Chicago/Turabian Style

Salmeri, Noemi, Antonio Farina, Massimo Candiani, Carolina Dolci, Giulia Bonavina, Caterina Poziello, Paola Viganò, and Paolo Ivo Cavoretto. 2022. "Endometriosis and Impaired Placentation: A Prospective Cohort Study Comparing Uterine Arteries Doppler Pulsatility Index in Pregnancies of Patients with and without Moderate-Severe Disease" Diagnostics 12, no. 5: 1024. https://doi.org/10.3390/diagnostics12051024

APA Style

Salmeri, N., Farina, A., Candiani, M., Dolci, C., Bonavina, G., Poziello, C., Viganò, P., & Cavoretto, P. I. (2022). Endometriosis and Impaired Placentation: A Prospective Cohort Study Comparing Uterine Arteries Doppler Pulsatility Index in Pregnancies of Patients with and without Moderate-Severe Disease. Diagnostics, 12(5), 1024. https://doi.org/10.3390/diagnostics12051024

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