Connie Rees

283 Mode of delivery also differed significantly between groups. Women with adenomyosis diagnosis had an aOR of 1.73 (95% CI 1.61-1.85) for caesarean delivery in general, and aOR of 1.54 (95% CI 1.41-1.70) for emergency caesarean delivery. The majority of emergency caesarean deliveries (59.9% vs 53.4% for adenomyosis and the general population respectively) were carried out due to failure to progress. No significant difference was found for instrumental delivery. There was a lower prevalence of antepartum haemorrhage in the adenomyosis group versus the general Dutch population (1.5% lower in prevalence, p<0.001). Women with adenomyosis showed an increased risk of hyperemesis gravidarum (aOR 2.07 (95% CI 1.52-2.82)). Women with adenomyosis also experienced more miscarriages (30.4% vs. 26.4%, aOR 1.53 (95% CI 1.44-1.62)). When looking at absolute values, no significantly increased prevalence of PPH could be found in the adenomyosis group (p= 0.194). When correcting for confounders however, a slightly increased risk for PPH was found in adenomyosis patients: aOR 1.23 (95% CI 1.10-1.38). Prevalence of endometritis was also increased in the adenomyosis group (aOR 1.70 (95% CI 1.02-2.82)). Women with adenomyosis showed an increased prevalence of placental retention, placenta previa, and placental abruption (see Table 2), however, only placenta previa and placental retention showed statistically significantly increased aORs when adjusting for confounders (aOR 2.13 (95% CI 1.36 – 3.34) and aOR 1.28 (95% CI 1.10 -1.48) respectively). When combining placental issues into a composite outcome, statistical significance remained, with a reported aOR 1.35 (95% CI 1.18-1.55), Several additional statistically significant differences were found between groups for other obstetric outcomes. An increased prevalence of foetal malposition (i.e. non-vertex lie) was seen in the adenomyosis group versus the general population (aOR 1.37 (95% CI 1.27-1.47)). Likewise, women with adenomyosis showed a higher prevalence for pain relief during labour (aOR 1.38 (95% CI 1.30-1.47)).

RkJQdWJsaXNoZXIy MTk4NDMw