STUDY QUESTION What are the pregnancy and obstetric outcomes in women with atypical hyperplasia (AH) or early-stage endometrial cancer (EC) managed conservatively for fertility preservation? SUMMARY ANSWER The study found a live birth rate of 62% in patients with AH or EC after conservative treatment, with higher level of labour induction, caesarean section, and post-partum haemorrhage. WHAT IS KNOWN ALREADY Fertility-sparing treatment is a viable option for women with AH or EC during childbearing years, but the outcomes of such treatments, especially regarding pregnancy and obstetrics, need further exploration. STUDY DESIGN, SIZE, DURATION This retrospective cohort study analysed data from January 2010 to October 2022, involving 269 patients from the French national register of patients with fertility-sparing management of AH/EC. PARTICIPANTS/MATERIALS, SETTING, METHODS Women above 18 years of age, previously diagnosed with AH/EC, and approved for fertility preservation were included. Patients were excluded if they were registered before 2010, if their treatment began <6 months before the study, or if no medical record on the pregnancy was available. MAIN RESULTS AND THE ROLE OF CHANCE In total, 95 pregnancies in 67 women were observed. Pregnancy was achieved using ART in 63 cases (66%) and the live birth rate was 62%, with early and late pregnancy loss at 26% and 5%, respectively. In the 59 cases resulting in a live birth, a full-term delivery occurred in 90% of cases; 36% of cases required labour induction and 39% of cases required a caesarean section. The most common maternal complications included gestational diabetes (17%) and post-partum haemorrhaging (20%). The average (±SD) birthweight was 3110 ± 736 g; there were no significant foetal malformations in the sample. No significant difference was found in pregnancy or obstetric outcomes between ART-obtained and spontaneous pregnancies. However, the incidence of induction of labour, caesarean section, and post-partum haemorrhage appears higher than in the general population. LIMITATIONS, REASONS FOR CAUTION The retrospective nature of the study may introduce bias, and the sample size might be insufficient for assessing rare obstetric complications. WIDER IMPLICATIONS OF THE FINDINGS This study offers valuable insights for healthcare providers to guide patients who received fertility-sparing treatments for AH/EC. These pregnancies can be successful and with an acceptable live birth rate, but they seem to be managed with caution, leading to possible tendency for more caesarean sections and labour inductions. No increase in adverse obstetric outcomes was observed, with the exception of suspicion of a higher risk of post-partum haemorrhaging, to be confirmed. STUDY FUNDING/COMPETING INTEREST(S) No funding was received for this study. There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.

中文翻译：

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子宫内膜癌和不典型增生的保留生育治疗后的妊娠和产科结果：一项多中心队列研究

研究问题 对于患有不典型增生 (AH) 或早期子宫内膜癌 (EC) 的女性，为了保留生育能力而进行保守治疗，妊娠和产科结果如何？摘要： 研究发现，AH或EC患者经过保守治疗后的活产率为62%，其中引产、剖腹产和产后出血的比例较高。已知信息 对于育龄期患有 AH 或 EC 的女性来说，保留生育能力的治疗是一种可行的选择，但此类治疗的结果，特别是在妊娠和产科方面，需要进一步探索。研究设计、规模、持续时间 这项回顾性队列研究分析了 2010 年 1 月至 2022 年 10 月的数据，涉及法国国家 AH/EC 保留生育管理患者登记册中的 269 名患者。参与者/材料、背景、方法 包括 18 岁以上、既往诊断为 AH/EC、并批准保留生育能力的女性。如果患者在 2010 年之前注册，如果他们的治疗在研究前 6 个月内开始，或者如果没有妊娠医疗记录，则患者被排除在外。主要结果和机会的作用 总共观察到 67 名妇女的 95 次怀孕。 63 例 (66%) 患者通过 ART 成功怀孕，活产率为 62%，早期和晚期流产率分别为 26% 和 5%。在 59 例活产病例中，90% 为足月分娩； 36%的病例需要引产，39%的病例需要剖腹产。最常见的产妇并发症包括妊娠糖尿病（17%）和产后出血（20%）。平均（±SD）出生体重为3110±736克；样本中没有发现明显的胎儿畸形。 ART 妊娠和自然妊娠之间的妊娠或产科结局没有显着差异。然而，引产、剖腹产和产后出血的发生率似乎高于一般人群。局限性、谨慎的原因该研究的回顾性可能会引入偏差，并且样本量可能不足以评估罕见的产科并发症。研究结果的更广泛意义 这项研究为医疗保健提供者提供了宝贵的见解，以指导接受 AH/EC 保留生育治疗的患者。这些妊娠可能会成功，并且活产率可以接受，但它们的管理似乎很谨慎，可能会导致更多剖腹产和引产的趋势。除了怀疑产后出血风险较高外，没有观察到不良产科结果增加，有待证实。研究资助/竞争利益 本研究未收到资助。没有需要申报的利益冲突。试用注册号 不适用。