Illustration showing the link between endometriosis and fetal membrane health during pregnancy.

Endometriosis and Pregnancy: Unveiling Hidden Risks in Fetal Membrane Health

Beau Callahan in Health & Wellness December 2025 • 4 min read.

"New research highlights structural changes in fetal membranes of women with endometriosis, potentially impacting pregnancy outcomes. Learn what these findings mean for you and your baby."

Endometriosis, a condition where tissue similar to the uterine lining grows outside the uterus, affects a significant number of women. While its impact on fertility is well-documented, its effects during pregnancy are still being unraveled. Recent studies suggest that endometriosis may contribute to adverse pregnancy outcomes, such as miscarriage and preterm birth.

A new study delves deeper into this connection, focusing on the fetal membranes (FMs) – the protective layers surrounding the baby. Researchers investigated whether women with deep infiltrating endometriosis (DIE) exhibit specific structural alterations in their FMs, potentially shedding light on the mechanisms behind pregnancy complications.

This article breaks down the key findings of this research, explaining the observed changes in the fetal membranes and discussing what they might mean for women with endometriosis and their pregnancies. We aim to provide clear, accessible information to empower you with knowledge about this complex condition.

Decoding Fetal Membrane Changes in Endometriosis

Illustration showing the link between endometriosis and fetal membrane health during pregnancy.

The study involved a detailed analysis of fetal membranes from 19 pregnant women with DIE and 8 women without endometriosis (the control group). All participants delivered via Cesarean section before labor to avoid any changes to the membranes caused by the birthing process. The researchers meticulously examined the FMs for structural differences.

Here's a breakdown of the key alterations observed in the fetal membranes of women with DIE:

Increased Thickness and Nodular Lesions: All FM samples from women with DIE showed increased thickness and small nodular lesions, particularly in the decidua (the maternal part of the placenta).
Vascular Abnormalities: Researchers noted increased microvessel formation and small hemorrhagic areas surrounding excrescences (small outgrowths) on the membranes.
Amnion and Chorion Alterations: Microscopic examination revealed fibrinoid necrosis (a type of tissue death) and connective tissue thickening in both the amnion and chorion layers. In some cases, the amniotic epithelial cells showed hyperplasia (excessive cell growth), forming papillary formations.
Trophoblast Disruption: In a significant number of samples, the trophoblast layer (which plays a crucial role in placental development) was disrupted by dense material, degenerated villi, and inflammatory infiltrates.
Decidual Changes: All samples from women with DIE showed degenerated cells within the decidual layer, along with the presence of cystic structures surrounded by large decidualized cells, small vessels, and inflammatory cells.

These findings suggest that endometriosis is associated with significant structural changes in the fetal membranes. The increased thickness, vascular abnormalities, and altered cellular structure could potentially impact the normal function of the membranes and contribute to pregnancy complications.

What Does This Mean for Women with Endometriosis?

The study highlights the importance of understanding how endometriosis can affect not just fertility, but also the health of the fetal membranes during pregnancy. While the exact clinical implications of these structural changes are still under investigation, they suggest a potential link between endometriosis and adverse pregnancy outcomes.

Further research is needed to fully understand how these FM alterations impact pregnancy and to identify potential interventions to improve outcomes for women with endometriosis. This may involve more systematic examination of FMs in women with DIE and exploring strategies to address the observed structural abnormalities.

If you have endometriosis and are planning a pregnancy or are currently pregnant, it's crucial to discuss these findings with your healthcare provider. They can provide personalized advice and monitoring based on your individual situation and help you navigate your pregnancy journey with the best possible care.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1177/1933719117728804, Alternate LINK

Title: Histopathological Alterations In Fetal Membranes Of Women With Endometriosis

Subject: Obstetrics and Gynecology

Journal: Reproductive Sciences

Publisher: Springer Science and Business Media LLC

Authors: Louis Marcellin, Céline Méhats, Jean Gogusev

Published: 2018-05-01

Everything You Need To Know

What specific structural changes in the fetal membranes are associated with deep infiltrating endometriosis?

Deep infiltrating endometriosis (DIE) is associated with several key structural alterations in the fetal membranes. These include increased thickness and nodular lesions primarily in the decidua, increased microvessel formation and hemorrhagic areas, fibrinoid necrosis and connective tissue thickening in the amnion and chorion layers, disruption of the trophoblast layer, and degenerated cells with cystic structures in the decidual layer. These changes could potentially impact membrane function and contribute to pregnancy complications.

How might the structural changes observed in the fetal membranes impact pregnancy?

The observed changes in the fetal membranes, such as increased thickness and vascular abnormalities, could potentially impact their normal function. The amnion and chorion layers are critical for providing structural support. Disruption of the trophoblast layer, which is vital for placental development, may also contribute to adverse outcomes. However, further research is needed to fully understand the clinical implications of these alterations.

How was the research conducted to identify structural alterations in the fetal membranes of women with deep infiltrating endometriosis?

The study focused on women with deep infiltrating endometriosis (DIE) who delivered via Cesarean section before labor. Fetal membrane samples from these women were compared to a control group of women without endometriosis. Researchers meticulously examined the fetal membranes for structural differences, including thickness, presence of lesions, vascular abnormalities, and cellular changes within the amnion, chorion, trophoblast, and decidual layers.

Besides structural changes to the fetal membranes, what other potential impacts of endometriosis on pregnancy were not directly addressed?

This study focused on structural changes within the fetal membranes. However, endometriosis can affect various other aspects of pregnancy, like the degree of inflammation within the uterus or placenta development. Further studies are needed to understand how these factors interact with the observed fetal membrane changes to influence pregnancy outcomes. Examining the interplay between these elements will provide a more comprehensive understanding of the risks associated with endometriosis during pregnancy.

Given these findings, what steps should women with endometriosis take to ensure a healthy pregnancy, and what further research is needed?

While the observed structural changes in the fetal membranes are significant, it is essential to consult with your healthcare provider for personalized advice. The clinical implications of these changes are still under investigation. Your doctor can assess your individual risk factors, monitor your pregnancy closely, and recommend appropriate management strategies based on the latest research and guidelines. Furthermore, these findings underscore the need for increased awareness and research into endometriosis and its effects on reproductive health.