E2736. Endometriosis During Pregnancy: Increasing Awareness to Avoid Misdiagnosis and Improve Outcomes
  1. Julia Saidman ; Hospital Italiano de Buenos Aires
  2. Pamela Causa Andrieu; Memorial Sloan Kettering Cancer Center
  3. Martina Aineseder ; Hospital Italiano de Buenos Aires
  4. Vlad Bura; Addenbrooke’s Hospital, Cambridge University Hospitals
  5. Priyanka Jha; University of California San Francisco
  6. Carolina Chacon; Hospital Italiano de Buenos Aires
  7. Liina Poder; University of California San Francisco
Endometriosis, mainly ovarian endometriomas and deep infiltrative endometriosis implants, are hormonally reactive and can respond to physiologic hormonal changes during pregnancy. This process leads to imaging appearance, which can mimic malignancy or have complications such as spontaneous hemoperitoneum or pseudoaneurysm. Moreover, adhesions from deep infiltrative endometriosis can restrict the uterus from growing out from the pelvis and lead to a partially “trapped” uterus.

Educational Goals / Teaching Points
To discuss the most common scenarios, the decidualization of endometriosis implants encountered in pregnant patients, highlighting the most common imaging findings on US and MRI. To discuss the differential diagnosis, especially the malignant counterpart, of such entities to avoid misdiagnosis. To discuss potential complications, such as pseudoaneurysm or entrapped uterus, contributing to making a correct early diagnosis and avoiding devastating outcomes.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Materials and methods discussion through the analysis of cases, mainly on US and MRI, correlating with surgical findings if available.

As imagers, we should be aware of the physiologic changes in the endometriosis spectrum during pregnancy and the common and uncommon manifestations of this common entity. Early recognition and proper diagnosis guide our referring physicians to manage these patients safely throughout pregnancy.