Adenomyosis and adverse perinatal outcomes: increased risk of second trimester miscarriage, preeclampsia, and placental malposition

<p><b>Objective:</b> To evaluate the potential impact of adenomyosis on the pregnancy outcomes by retrospectively investigating adenomyosis-complicated pregnancy cases.</p> <p><b>Methods:</b> We performed a retrospective case–control study. Forty-nine singleton pregnancy cases complicated with adenomyosis were included in this study. The controls (<i>n</i> = 245) were singleton pregnant women without adenomyosis and were frequency matched to adenomyosis cases by age, parity, and the need for assisted reproductive technology for this conception. The incidence of obstetrical complications and delivery and neonatal outcomes were examined.</p> <p><b>Results:</b> Patients in the adenomyosis group were significantly more likely to have a second trimester miscarriage (12.2% versus 1.2%, odds ratio (OR): 11.2, 95% confidence interval (95% CI): 2.2–71.2), preeclampsia (18.3% versus 1.2%, OR: 21.0, 95% CI: 4.8–124.5), placental malposition (14.2% versus 3.2%, OR: 4.9, 95% CI: 1.4–16.3), and preterm delivery (24.4% versus 9.3%, OR: 3.1, 95% CI: 1.2–7.2), compared with the control group.</p> <p><b>Conclusion:</b> Adenomyosis was associated not only with an increased incidence of preterm delivery, as previously reported, but also with an increased risk of second trimester miscarriage, preeclampsia, and placental malposition, which could lead to poor perinatal outcomes.</p

Additional file 1: of Expression of the glucagon-like peptide-1 receptor and its role in regulating autophagy in endometrial cancer

Table S1. Detailed data of participants. Clinicopathological data of 154 patients with endometrial cancer who underwent surgery at the Teikyo University Hospital. These clinical characteristics were obtained by a retrospective review of medical records and the pathological data were obtained by our tissue microarray. (XLSX 14 kb

Illustrations of sample excision for decellularization and in-vivo study.

<p>Illustrations of sample excision for decellularization and in-vivo study.</p

Qualitative observation of reconstructed uterus at days 30 for collagen (MT) and elastin (VVG), respectively, in sham (A and D), SDS 1% for 1 hour (B and E) and HHP 30-4 (C and F); and quantitative analysis of hydroxyproline (G) and elastin (H).

<p>Arrows in the picture indicate the interface of implant and native tissue. Data are presented as mean ± SE.</p

Numbers of fetuses in the reconstructed uterine horns on day 21 of pregnancy.

<p>Data are presented as mean ± SE.</p

Qualitative observation of reconstructed uterus for tissue regeneration at days 30 (H&E, vimentin and α-SMA) and blood vessel (CD31), respectively, in sham (A, D, G and J), SDS 1% for 1 hour (B, E, H and K) and HHP 30-4 (C, F, I and L), and quantitative analysis of DNA contents (M).

<p>Data are presented as mean ± SE. Arrows in the picture indicate the interface of implant and native tissue.</p

Mechanical properties of reconstructed uterus at day 30.

<p>Young’s modulus (A), rupture stress (B) and thickness (C). Data are presented as mean ± SE.</p

Immunostaining of Ki67 (A–C) and estrogen receptor (ER, D–F), respectively, in sham (A and D), SDS 1% for 1 hour (B and E) and HHP 30-4 (C and F) at days 30.

<p>Arrows in the picture indicate the interface of implant and native tissue.</p

Quantification of protein contents of native and decellularized uterine tissue in terms of the temporal change of the DNA amount (A), contents of DNA (B), hydroxyproline (C) and elastin (D).

<p>Data are presented as mean ± SE. Bars indicate p<0.05.</p

Photograph of native uterus (A) and reconstructed uterus (B) with excision sites as labelled.

<p>Photograph of native uterus (A) and reconstructed uterus (B) with excision sites as labelled.</p