Strengths and limitations
A strength of our study is that, to the best of our knowledge, this is
the first report to show the clinical characteristics of pain at the
adenomyosis site during pregnancy. Another limitation is that we did not
confirm the imaging findings that are linked to the manifestation of
adenomyosis pain. However, as with degeneration in fibroids, diagnosis
of adenomyosis pain during pregnancy seems sufficient to confirm the
tenderness over the adenomyosis lesion with ultrasound after carefully
excluding the possibility of intra-amniotic infection (IAI). Moreover,
to elucidate the pathophysiology of pain at the adenomyosis site,
pathological confirmation of the histological change in adenomyosis is
warranted in future studies.