Ivo A Brosens1, Marit C Lier2, Velja Mijatovic2, Marwan Habiba3, Giuseppe Benagiano4. 1. Leuven Institute for Fertility and Embryology, Leuven, Belgium. Electronic address: ivo.brosens@med.kuleuven.be. 2. Endometriosis Center VUmc, Department of Reproductive Medicine, VU University Medical Center, Amsterdam, the Netherlands. 3. Department of Obstetrics and Gynecology, Leicester Royal Infirmary, University Hospitals of Leicester, Leicester, United Kingdom. 4. Department of Gynecology, Obstetrics, and Urology, Sapienza, University of Rome, Rome, Italy.
Abstract
OBJECTIVE: To evaluate existing evidence of a possible association in women with endometriosis between controlled ovarian hyperstimulation plus embryo transfer (COH-ET) and the occurrence of spontaneous hemoperitoneum in pregnancy (SHiP). DESIGN: Comprehensive review. SETTING: Not applicable. PATIENT(S): None. INTERVENTION(S): An electronic literature search up to February 2016 was conducted using Scopus and PubMed. MAIN OUTCOME MEASURE(S): The role of COH-ET in SHiP. RESULT(S): Controlled ovarian hyperstimulation plus embryo transfer may increase the severity or incidence of the rare condition known as SHiP. An analysis of published cases shows that bleeding often occurs from multiple or diffuse sites, mainly situated in the posterior pelvic cavity, making it difficult to control without interfering with the pregnancy itself. Spontaneous hemoperitoneum in pregnancy is linked to adverse perinatal outcomes, including stillbirth, neonatal mortality, and very low or low birth weight. In 14 cases a biopsy of the bleeding site was obtained, and in all cases, even in the absence of visible endometriosis, decidualization was documented. At present, the relatively small number of cases published prevents firm conclusions, although they are highly suggestive of a link between COH-ET in women with endometriosis and the occurrence and seriousness of SHiP. CONCLUSION(S): Spontaneous hemoperitoneum in pregnancy is a rare but potentially fatal complication for the pregnant woman and her unborn child. In vitro fertilization in women with severe endometriosis may be a risk factor for SHiP.
OBJECTIVE: To evaluate existing evidence of a possible association in women with endometriosis between controlled ovarian hyperstimulation plus embryo transfer (COH-ET) and the occurrence of spontaneous hemoperitoneum in pregnancy (SHiP). DESIGN: Comprehensive review. SETTING: Not applicable. PATIENT(S): None. INTERVENTION(S): An electronic literature search up to February 2016 was conducted using Scopus and PubMed. MAIN OUTCOME MEASURE(S): The role of COH-ET in SHiP. RESULT(S): Controlled ovarian hyperstimulation plus embryo transfer may increase the severity or incidence of the rare condition known as SHiP. An analysis of published cases shows that bleeding often occurs from multiple or diffuse sites, mainly situated in the posterior pelvic cavity, making it difficult to control without interfering with the pregnancy itself. Spontaneous hemoperitoneum in pregnancy is linked to adverse perinatal outcomes, including stillbirth, neonatal mortality, and very low or low birth weight. In 14 cases a biopsy of the bleeding site was obtained, and in all cases, even in the absence of visible endometriosis, decidualization was documented. At present, the relatively small number of cases published prevents firm conclusions, although they are highly suggestive of a link between COH-ET in women with endometriosis and the occurrence and seriousness of SHiP. CONCLUSION(S): Spontaneous hemoperitoneum in pregnancy is a rare but potentially fatal complication for the pregnant woman and her unborn child. In vitro fertilization in women with severe endometriosis may be a risk factor for SHiP.
Authors: Loukia Vassilopoulou; Michail Matalliotakis; Maria I Zervou; Charoula Matalliotaki; Demetrios A Spandidos; Ioannis Matalliotakis; George N Goulielmos Journal: Exp Ther Med Date: 2018-06-13 Impact factor: 2.447