Research recommendations
Future studies are warranted to delineate the pathophysiology by which
pain is induced in adenomyosis lesion during pregnancy. Confirming the
histologic features of adenomyosis lesion during pregnancy may aid in
elucidating the underlying pathophysiology, although the pathology of
the uterus and the adenomyosis lesion during pregnancy is difficult to
determine owing to the nature of the disease. Considering the difficulty
of obtaining diagnostic confirmation based on histologic features,
confirmation of the adenomyosis lesion with serial MRIs before
conception and during adenomyosis pain, as shown previously, (11) (24)
may aid in delineating the pathophysiology of the adenomyosis pain
during pregnancy; therefore, more reports based on serial MRI findings
are awaited. After accumulation of these data, it may be possible to
unravel the characteristic findings of adenomyosis which lead to
adenomyosis pain during pregnancy.
Future research should aim to elucidate the pain mechanism in
adenomyosis as associated with the onset of PE. PE is a multifactorial
disease, and one of the known pathophysiology that may trigger the onset
of PE is enhanced inflammation.(33, 34) However, the precise mechanism
by which the inflammation induces PE is yet to be elucidated. Moreover,
the type of adenomyosis or the maternal background associated with the
onset of the adenomyosis pain during pregnancy and subsequent PE cannot
be concluded from our small sample size; therefore, more reports on this
phenomenon are warranted for further evaluation. Elucidating the
mechanism by which PE is induced from adenomyosis pain may in turn
unravel one aspect of the pathophysiology of PE.