Abstract:

Objective

To investigate the value of cervical polypectomy via vaginoscopy in pregnant women.

Methods

The pregnant woman with cervical polyps were retrospectively included in Beijing Tiantan Hospital， Capital Medical University from Apr. 2017 to Dec. 2023. A vaginoscopy technique for cervical polypectomy without a speculum， cervical forceps， and anesthesia was applied for surgery group， and conservative management was used for observation group. The rate of spontaneous abortion， preterm birth，preterm rupture of membranes （PROM）， the timing and mode of delivery， and neonatal outcomes were analyzed.

Results

100 pregnant patients with cervical polyps who underwent cervical polypectomy were included into surgery group （n=55） and patients without operation were assigned to observation group （n=45）. At baseline， the rate of vaginal bleeding pre-operation， the length and width of the cervical polyp were higher in surgery group than in observation group. The median interval from vaginal bleeding to polypectomy was 4 weeks and the median time of polypectomy was performed at gestational week 18 . There was no difference on the incidence of spontaneous abortion in two groups （3.6% vs. 4.4%，P＞0.05）. However， a significantly lower frequency of preterm birth （7. 3% vs. 22. 2%，P ＜0. 05） and PROM （20. 0% vs.45.2%，P＜0.05） were observed observation. There was no difference in the timing， mode of delivery， and neonatal outcomes in both groups.

Conclusions

The vaginoscopy for cervical polypectomy without anesthesia may be a feasible management for pregnant women with vaginal bleeding.The cervical polypectomy under vaginoscopy reduced the risk of preterm delivery and PROM in pregnant women with symptomatic cervical polyps.

Key words: Vaginoscopy, Cervical polyp, Polypectomy