Perinatal Consequences of Endometriosis

Study Overview
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Brief Summary
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Endometriosis is a benign gynecological disease, characterized by the presence of endometrium-like tissue outside the uterine cavity that affect up to 10-15% of women in reproductive age worldwide, with an extensive impact on women's wellbeing and their reproductive life. Endometriosis lesions are heterogeneous and three phenotypes of the disease are well recognized and are fundamentally different from each other: superficial peritoneal endometriosis (peritoneal implants), ovarian endometrioma (cyst ovarian endometriosis), and deeply infiltrating endometriosis (invasive nodules greater than 5 mm). The investigators performed a prospective multicenter comparative study to assess the maternal and fetal risks related to endometriosis during pregnancy, regarding disease phenotype, This study will evaluate with sufficient power the risk of prematurity and obstetrical complications associated with endometriosis according to disease phenotype. This study aims to provide new informations to pregnant women with endometriosis, guide the monitoring of pregnancy, optimize management strategies based on the nature of complications and ultimately to improve the health of women and their unborn child

Detailed Description
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Design selected and justification: the study ENDOBST is a exposed / unexposed type in superiority with two comparative groups (endometriosis / without endometriosis) Ratio of distribution of subjects in study groups = 1: 2 ENDOBST is a comparative prospective multicenter study presentation exposed - unexposed type. The study aims to compare the outcomes of pregnancy in the whole exposed group to controls and then according to the three disease phenotype (superficial, ovarian, and deep endometriosis). Endobst aims to test the hypothesis that women with endometriosis have an increased risk of preterm delivery (primary endpoint) and an increased risk of pregnancy complications (secondary endpoints) when compared to diseases-free women. Comparisons will be performed according to disease phenotype. These analyzes will be conducted after taking into account factors likely to influence the occurrence of preterm birth such as particularly social characteristics (education level, employment status), age and body mass index of women, pathological medical and obstetrical history and behavioral factors (tobacco). Secondary analyzes will be conducted to investigate the link between endometriosis, and other adverse pregnancy outcomes (premature rupture of membranes, intrauterine growth restriction), complications related to the surgical treatment endometriosis prior to pregnancy. Regarding the previous surgical treatment, the subgroup of women operated for their endometriosis will be compared to the subgroup of non-operated endometriosis in women and free subset of women. Particular attention will be paid to the phenotype of endometriosis and the nature of previous surgical treatment for pregnancy to control bias indication inherent in observational studies. These associations will be studied from multivariate regression models.

Official Title
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Perinatal Consequences of Endometriosis: Multicenter Prospective Comparative Study

Conditions
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Endometriosis

Intervention / Treatment
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* Biological: Biological collection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient major Single Pregnancy Patient followed before 22 SA and giving birth in the maternity ward in the study Affiliated to health care Exclusion Criteria: Opposition to the use of personal medical data or medical data of their child for research purposes Pregnant women with multiple pregnancies HIV positive women Patients addressed in the center as part of a transfer in utero. Women whose pregnancy is complicated by a spontaneous miscarriage before 15 weeks

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Type exposed<br>endometriosis | Biological: Biological collection<br>* Blood and saliva samples, placenta and cord blood collection<br>|
| Experimental: Type unexposed<br>Without endometriosis | Biological: Biological collection<br>* Blood and saliva samples, placenta and cord blood collection<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of preterm delivery | Each delivery greater than or equal to 22 weeks and less than 37 weeks | at Day 0 until 26 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| premature rupture of membranes |  | at Day 0 until 26 weeks | 
| fetal loss |  | at Day 0 until 11 weeks | 
| intrauterine growth restriction |  | at Day 0 until 31 weeks | 
| induced or spontaneous preterm birth |  | at Day 0 until 26 weeks | 
| preeclampsia |  | at Day 0 until 31 weeks | 
| placenta previa |  | at Day 0 until 31 weeks | 
| postpartum hemorrhage |  | at 11 weeks until 31 weeks | 
| number of caesarean |  | at 11 weeks until 31 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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endometriosis, preterm delivery, caesarean, Pregnancy outcomes of women with or without endometriosis