Abstract
Research Question
: Adenomyosis comprises diffuse and focal phenotypes. It has been suggested that pregnancy
may play a central role in the pathogenesis of the diffuse phenotype. There is, however,
a lack of data regarding the impact of pregnancy on adenomyosis. Therefore, the objective
of this study was to assess the changes of magnetic resonance imaging criteria of
adenomyosis before and after pregnancy.
Design
: A retrospective, monocentric, observational study in a single academic tertiary
referral center for endometriosis diagnosis and management. Women followed for symptomatic
adenomyosis, diagnosed by magnetic resonance imaging, and without a prior history
of surgery who give birth after 24+0 weeks. For each patient, pelvic magnetic resonance
imaging pre- and post-pregnancy was performed by two experienced radiologists with
the same image acquisition protocol. Diffuse and focal adenomyosis MRI presentation
before and after pregnancy.
Results
: Between January 2010 and September 2020, of the 139 patients analyzed, 22 (15.8%)
presented diffuse adenomyosis, 55 (39.6%) focal adenomyosis, and 19 (13.7%) both phenotypes.
The frequency of isolated diffuse adenomyosis on MRI was significantly lower before
versus after pregnancy (n=22 (15.8%) vs. n=41 (29.5%), p=0.01). The frequency of isolated
focal adenomyosis was significantly higher before pregnancy than after pregnancy (n=55
(39.6%) vs. n=34 (24.5%), p=0.01). The mean volume of all focal adenomyosis lesions
decreased significantly after pregnancy on MRI, from 6.7 ± 2.5 mm3 to 6.4 ± 2.3 mm3, p<0.01.
Conclusion
: Our data indicated that, based on MRI, there is an increase in diffuse adenomyosis
and a decrease in focal adenomyosis after pregnancy.
Keywords
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Biography
Doctor Louis MARCELLIN, M.D., Ph.D.: Graduated from the University Paris Descartes, Faculty of Medicine, Louis MARCELLIN was named Associated Professor in 2017 in the department of Obstetrics and Gynecology and Reproductive Medicine at Cochin University Hospital (Paris, France) headed by Prof. Charles CHAPRON.
Article info
Publication history
Accepted:
February 20,
2023
Received in revised form:
February 5,
2023
Received:
November 6,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
