Millions of women with a painful womb condition should be monitored much more closely in pregnancy because they are at a higher risk of losing their babies, doctors said last night.

They spoke out after a major study showed that endometriosis, which affects around one in ten women, raises the odds of a host of complications in pregnancy.

These range from miscarriages and premature birth to potentially deadly haemorrhages.

But watching these women more closely could reduce the danger – and save their life and that of their baby.

Endometriosis occurs when cells normally found in the womb lining attach themselves to other parts of the pelvic area, causing scarring, inflammation and pain.

It was known to cause fertility problems, but it had been thought that once a woman did conceive, the condition was unlikely to put her pregnancy at risk.

However, the issue had not been thoroughly researched. Now, Aberdeen University researchers have trawled through 30 years of medical records in Scotland, allowing them to compare pregnancies of women who have endometriosis with those of women without the condition.

The analysis of more than 15,000 pregnant women showed that those with endometriosis were 76 per cent more likely to miscarry.

They also had almost triple the chance of suffering an ectopic pregnancy – when the embryo implants outside the womb and the baby is lost.

Women with endometriosis also have a higher risk of complications later in pregnancy such as giving birth prematurely and haemorrhaging, which can be fatal, the European Society of Human Reproduction and Embryology’s annual conference in Lisbon heard.

It is thought that the complications happen because endometriosis damages the development of the placenta – the lifeline between mother and unborn child. Doctors suggested women with endometriosis should give birth in hospitals with specialist neonatal units so that expert help is on hand.

Researcher Lucky Saraswat, a consultant gynaecologist at Aberdeen Royal Infirmary, said that miscarriages and ectopic pregnancies sadly can’t be prevented – so in these cases the baby cannot be saved. 

But if doctors know that women with endometriosis are more at risk, they can monitor them more closely and admit them to a specialist unit at the first sign of trouble – limiting the dangers to the mother.

Catching a haemorrhage early can save the life of both the mother and child.

Dr Saraswat said: ‘These findings should be used to counsel women with endometriosis and inform them.

‘At the moment, once they are diagnosed with endometriosis, we talk about infertility but we do not talk about what happens once they get pregnant. 

'These finds can also be taken into account when planning antenatal care for these women.’

Professor Adam Balen, chairman of the British Fertility Society, said it is particularly important that women in rural areas who are at risk of complications are on the radar of hospitals with specialist units.

He added: ‘If you have an antenatal haemorrhage, you have to act swiftly to save the baby.’

Charles Kingsland, of the Hewitt Fertility Centre at Liverpool Women’s Hospital, said: ‘There is no doubt that these women and their babies are at higher risk throughout their pregnancies.’

Written by Fiona Macrae

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