OUTCOME OF PREGNANCY FOLLOWING ENDOMETRIAL ABLATION

Pregnancy following endometrial ablation is uncommon, and the literatu re does not allow an estimation of the likelihood of complications. Wo men with Asherman's syndrome, which is regarded as similar to a postab lation uterus, have a 30% chance of progressing to term delivery. We r eport four pregnancies following endometrial ablation, bringing the to tal number of published cases to 37. The outcomes are analyzed to prov ide evidence for patient counseling and for management of those women who are pregnant following endometrial ablation. Just over half of the reported pregnancies following endometrial ablation were therapeutica lly aborted, and an additional 11% aborted spontaneously. The 11 conti nuing pregnancies were complicated by perinatal death in 2 (18%) and i ntrauterine growth retardation in 5 (45%). There was premature rupture of membranes in 3 (27%), preterm delivery in 7 (64%), and placenta ac creta in 6 (55%). Preterm deliveries were by emergency cesarean sectio n, except in 1 case, and all placental adherence complications occurre d in this group. Three women required hysterectomy. Only 4 (36%) conti nuing pregnancies reached term, and 3 of these were delivered by elect ive cesarean section. No term pregnancy had a third stage complication .