The efficacy and safety of trans-vaginoscopy cervical polypectomy during pregnancy

Abstract

Purposes: To investigate efficacy and safety of cervical polypectomy under vaginoscopy in pregnant women. Methods The pregnant patients with cervical polyps were retrospectively included in Beijing Tiantan Hospital, Capital Medical University from April 2017 to April 2023. A vaginoscopy technique for cervical polypectomy without a speculum, cervical forceps, and anesthesia was applied for group A, and conservative management was used for group B. The rate of spontaneous abortion, preterm birth, preterm rupture of membranes (PROM), the timing and mode of delivery, and neonatal outcomes were analyzed. Results 90 pregnant patients with cervical polyps who underwent cervical polypectomy were included into group A (n = 48) and patients without operation were assigned to group B (n = 42). At baseline, the rate of vaginal bleeding pre-operation, the length and width of the cervical polyp were higher in group A than in group B. The median interval from vaginal bleeding to polypectomy was 3.5 weeks and the median time of polypectomy was performed at gestational week 19 in group A. There was no difference on the incidence of spontaneous abortion in two groups (4.2% vs. 4.8%, p = 1.000). However, a significantly lower frequency of preterm birth (4.2% vs. 21.4%, p = .030) and PROM (18.8% vs. 45.2%, p = .025) were observed in group A than in group B. There was no difference in the timing, mode of delivery, and neonatal outcomes in both groups. Conclusions The cervical polypectomy under vaginoscopy reduced the risk of preterm delivery and PROM in pregnant women with symptomatic cervical polyps.