Objective: Endometriosis is defined as the presence of endometrial-like tissue outside the uterus, associated with pelvic pain and subfertility, affecting 0.6–10% of the general female population. The association between endometriosis and obstetrical outcomes is not well established. We aimed to evaluate whether endometriosis is associated with a higher incidence of obstetrical and neonatal complications. Study design: A retrospective cohort study of all deliveries in a university-affiliated tertiary hospital (2007–2014). Eligibility was limited to women with previously diagnosed endometriosis and singleton pregnancies. Fetuses or neonates diagnosed with structural or chromosomal anomalies were excluded. We compared labor and delivery outcomes and immediate neonatal outcomes among women with endometriosis compared with women without endometriosis. Results: Overall, 61,535 deliveries were eligible for analysis, of which 135 (0.002%) had endometriosis. Women with in the endometriosis group were characterized by higher maternal age, lower parity and higher nulliparity rate, and an earlier gestational age at delivery. Women with endometriosis had higher rate of failure of induction of labor (aOR 5.2, 95%CI 1.8–14.9), cesarean delivery (aOR 5.0, 95%CI 3.3–7.4), postpartum hemorrhage (aOR 3.7, 95%CI 1.6–8.5), placenta accreta (aOR 6.24, 95%CI 2.20–17.67), postpartum hemoglobin <10 mg/dL (aOR 2.03, 95%CI 1.31–3.14), and packed cell transfusion (aOR 3.66, 95%CI 1.94–6.91). No significant differences in neonatal outcomes were observed. Conclusions: Endometriosis is associated with higher risk of cesarean delivery and postpartum hemorrhage. Our findings suggest appropriate preparations for delivery, such as uterotonic agents and blood products, should be considered in these women.

Objective This study aims to determine the impact of meconium-stained amniotic fluid (MSAF) in low-risk pregnancies at term on pregnancy outcome. Study Design A retrospective cohort study of women with MSAF during labor who delivered in a tertiary hospital at 37 to 41⁺⁶ weeks of gestation (2007–2013). Exclusion criteria included: multiple gestations, noncephalic presentation, fetal structural/chromosomal anomalies, hypertensive disorders, diabetes, oligohydramnios, or small for gestational age. Pregnancy outcome of women with MSAF (N = 4,893) was compared with a control group of women without MSAF (N = 39,651). Neonatal respiratory morbidity was defined as the presence of any of the following: respiratory distress syndrome, transient tachypnea of the newborn, meconium aspiration syndrome, or need for ventilatory support. Results Overall, 10.9% of low-risk pregnancies at term were diagnosed with MSAF. Compared with the controls, women with MSAF had higher rates of nulliparity, gestational age at delivery ≥ 41 weeks, induction of labor, nonreassuring fetal heart rate, and operative deliveries. In multivariate analysis MSAF was associated with operative delivery (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.63–2.09; p < 0.001), cesarean section (OR, 1.48; 95% CI, 1.31–1.69; p < 0.001), respiratory morbidity (OR, 4.74; 95% CI, 3.87–5.82; p < 0.001), and increased risk for short-term neonatal morbidity. Conclusions MSAF is associated with a higher rate of adverse perinatal outcome even in low-risk pregnancies at term.