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PREVALENCE OF ENDOMETRIOSIS AMONGST WOMEN UNDERGOING DIAGNOSTIC LAPAROSCOPY FOR CHRONIC PELVIC PAIN AND INFERTILITY AND ITS ASSOCIATION WITH ABO BLOOD GROUP SYSTEM
Abstract
Background: Endometriosis constitutes a very important problem in gynaecological practice especially with respect to infertility and chronic pelvic pain. The relationship of endometriosis with ABO blood group system remains a controversial issue. Other risk factors like prolonged period of menstruation, personal habits and familial tendency have been implicated.
Setting: Gynaecological clinic of the University College Hospital, Ibadan.
Objectives: To study the prevalence of endometriosis among women undergoing diagnostic laparoscopy for chronic pelvic pain and infertility and its relationship with ABO blood group system and other risk factors.
Methodology: Fifty five women being evaluated for chronic pelvic pain and infertility with laparoscopy had their blood samples taken for blood grouping. Their demographic data and history were taken. Physical and pelvic examinations were performed and relevant information filled in the questionnaire. Endometriosis was diagnosed using diagnostic out-patient laparoscopy under conscious sedation. Staging was done using revised classification of the American Society of Reproductive Medicine
Results: Of 55 patients that underwent laparoscopy for chronic pelvic pain and infertility, 14 (25.5%) had endometriosis. Majority(29.1%) were over 35years of age, civil servants (49.1%), had tertiary education (70.8%), Yoruba (61.8%), attained menarche at 12 years or less (71.4%), menstruated for 5days or more (92.9%) and did mild exercise (92.7%). Only four (7.3%) were alcohol users and five (9.1%) consumed caffeine. Twenty eight (50.9%) had pelvic pains and thirty four (61.8%) presented with infertility. Menstrual irregularity (polymenorrhea) was found in nine (16.4%) of the respondents. Majority (54.5%) had blood group O and forty five (81.8%) were rhesus positive. There were no statistically significant association between endometriosis and occupation (P=0.48), level of education (P=0.21), tribe (P=0.11), parity (P=0.36), alcohol consumption (P=0.27), caffeine consumption (P=0.98), smoking (P=1.00), degree of physical exercise (P=0.562), blood group of the patient (P=0.56), and presence or absence of rhesus factor (P=0.72). However, only age at menarche (P<0.001), duration of menstrual flow (P<0.001) and polymenorrhea (P<0.001) were significantly associated with endometriosis in this study. Early age at menarche and polymenorrhea were the strongest predictors.
Conclusion: Endometriosis is commoner than previously believed and is associated with early age at menarche, prolong duration of menstrual flow and polymenorrhea. The association of endometriosis with ABO blood group system is not statistically significant. However, more studies need to be conducted in this environment to explore its relationship with ABO blood group system and lifestyle-related risk factors.
