What Should You Know About Endometriosis During Pregnancy?

Endometriosis occurs when tissue similar to the uterine lining grows outside of the uterus. It affects 6-10%  of women in the United States, can cause severe menstrual pain, and may make conception or pregnancy difficult.

Although 70% of women with mild to moderate endometriosis can become pregnant and have no problems with their pregnancy, (regardless of how their endometriosis is treated) it is important to understand the risk factors and implications when it comes to pregnancy.

What happens during pregnancy with endometriosis?

Sometimes, pregnancy can actually lessen endometriosis symptoms due to increased progesterone levels that occur. Progesterone’s synthetic counterpart, progestin, has been demonstrated to lessen endometriosis pain in 90% of women.

This relief of symptoms is not always guaranteed, however. In some cases, pregnancy can worsen endometriosis symptoms due to the uterus’s continuous expansion, or increased levels of estrogen, which may incite more endometrium growth. Even if pregnancy relieves your symptoms, it is not a cure, and endometriosis difficulties can return afterward.

Pregnancy Risk Factors

Along with fluctuating symptoms, there are a few more conditions to watch for during pregnancy if you have endometriosis:

Placenta Previa (Low-Lying Placenta)

Placenta previa refers to a condition when the placenta covers, or almost covers, your cervix. This can cause bleeding throughout the pregnancy and delivery. Placenta previa is commonly associated with endometriosis and often results in the recommendation of a C-section.

Ectopic Pregnancy

Ectopic pregnancies occur when a fertilized egg begins to grow outside the uterus, such as in the fallopian tubes, and endometriosis increases your risk. While ectopic pregnancies can present in the same ways as conventional ones, consultation with your doctor is needed. Symptoms of ectopic pregnancy include lower back pain, vaginal bleeding, or mild pelvic cramping.

Preterm Birth

A birth is determined “preterm” if the fetus is delivered before the mother’s 37th week of pregnancy. Women with endometriosis have a 33% greater risk of preterm birth. If you have been diagnosed with endometriosis, stay in close communication with your doctor (and your own body) during your first two trimesters.

Miscarriage

A miscarriage occurs when the pregnancy is lost before the mother reaches her 20th week of pregnancy. Endometriosis can significantly increase the risk of a miscarriage, but continuously monitoring with your doctor can alert you to possible warning signs, so you both can take preventative measures that will help you carry to term.

What can you do?

To prepare for pregnancy with endometriosis, you may consider surgery or hormone therapy treatment ahead of time. Surgery involves removing patches of the outside lining, while hormone therapy may reduce excess tissue, although often comes with undesirable side effects. In-vitro fertilization (IVF) is another procedure that may assist with conception, should endometriosis cause challenges.

Above all, prior to conception and throughout your pregnancy, always express your worries to your doctor and monitor your symptoms with them together. Frequent visits, clear communication, and strong awareness of your body can all help minimize complications.

If you have endometriosis or suspect you may, are looking to conceive, or are already pregnant, we are here to provide you with exceptional care. Call us for an appointment at (770) 385-8954 or schedule one online.

 

A Brief History of Gynecology and Its Impacts In Today’s World

At Covington Women’s Health Specialists, we share valuable knowledge about pregnancy, maternity, delivery, and other women’s health issues with our patients. So, for Women’s History Month, we’re taking a look back at some highlights from gynecology’s history, and how the study and practice is evolving for future generations.

Ancient Beginnings

Composed in 1800 BC during the Twelfth Egyptian Dynasty, the Kahun Gynecological Papyrus is credited as “the oldest available medical record of Egyptian civilization,” and may be the earliest record we have detailing gynecological care. Three pages long, it focuses on fertility, pregnancy, contraception, and gynecological diseases.

An example from this text demonstrates gynecology’s humble beginnings 4000 years ago, including treatment involving “fumigating her with incense and fresh oil, fumigating her womb with it, and fumigating her eyes with goose leg fat.”

Though the Kahun papyrus is a highly valuable artifact which documents an early dedication to women’s health issues, it’s possible that the study of gynecology and obstetrics was also practiced in other ancient cultures and early time periods — but that those records and practices have simply been lost to history.

Gynecology practices have clearly come a long way, regardless.

19th Century “Progress”

Dr. James Marion Sims is widely credited as the “father of modern gynecology” in America. In the late 1880s, he pioneered surgical tools and techniques, including the repair of vesicovaginal fistula — a life-improving procedure still conducted to this day.

During this time period, practicing medicine on women was rarely done, but Sims became intrigued when asked to assist a woman suffering pelvic and back pain after falling off her horse. “To treat this woman’s injury,” HISTORY reports, “Sims realized he needed to look directly into her vagina…. This discovery helped him develop the precursor to the modern speculum: the bent handle of a pewter spoon.”

For these advances, Sims has been long heralded. But even in his own autobiography, Sims admits his techniques were perfected by experimentation — on Black slave women. Modern critics also assert these experiments were performed without anesthesia. As a result, in 2017 his statue was removed in New York City’s Central Park. The courage of these women and their sacrifices must be acknowledged.  They and many men in similar situations are now recognized as true heroes in the discovery of many medical advances.

Though a valuable contributor to the progress of gynecology, Sims serves as a reminder of the uncredited and often unwilling sacrifices possibly countless women have made for its sake, and the vital importance of both consent and women’s whole well-being while pursuing medical advances.

20th Century Strides and 21st Century Promise

The 20th century presented significant breakthroughs for gynecology, including widely-available oral contraceptives and safe IUDs, the evolution of artificial insemination to in-vitro fertilization, the success of cancer-detecting Pap smears, and the use of ultrasounds to provide greater visibility into a variety of women’s health issues, from pregnancy to uterine fibroids and ovarian cysts.

Perhaps some of this progress is due to the expansion and exposure of women’s rights, including more women becoming physicians, medical researchers, and OB-GYNs. “One of the steadiest movements has been the rise in women as a percentage of the physician workforce: It rose from 28.3% in 2007 to 36.3% last year,” the Association of American Medical Colleges reports. They also note that specialties with the highest concentration of women include:

  • Pediatrics — 64.3%
  • Obstetrics and gynecology — 58.9%
  • Child and adolescent psychiatry — 54.0%
  • Neonatal-perinatal medicine — 52.8%

There is interesting debate regarding these concentrations of focus, and much progress in terms of diversity is still to be made. Some more modern gynecological advances such as vaginal mesh implants are also currently under scrutiny — evidence that there is still work to be done.

With a future that could include 3-D printed ovaries for infertile patients, the use of artificial intelligence in gynecology and obstetrics, and continued education about the importance of midwifery in both the past and present, obstetrics and gynecology may look very different in even another 10 years — let alone 4000.

For up-to-date, caring, women-centered health advice and services, call us for an appointment at (770) 385-8954 or schedule one online.