Analysis Of Pregnancy Outcomes And Influencing Factors In Pregnant Women With Cervical Polyps During Pregnancy

Objective:Through a retrospective analysis,explore the possible impact of cervical polyps during pregnancy on pregnancy outcomes,and further analyze the relevant factors of adverse pregnancy outcomes in patients undergoing surgical treatment during pregnancy.Apply the results to clinical reference,reasonably select the treatment method,operation time,relieve the symptoms of pregnancy,and improve the pregnancy experience and outcome of pregnant women.By avoiding the occurrence of related adverse factors,reducing the occurrence of complications of cervical polypectomy,improving the prognosis and reducing the incidence of adverse pregnancy outcomes.Provide new ideas and reference evidence for clinicians’clinical decision-making and individualized diagnosis and treatment of patients.Methods:192 cases of pregnancy complicated with polyps who were diagnosed in Shenyang Women’s and Children’s Hospital from July 2019 to July 2021 were selected for retrospective analysis.First,all of the patients were divided into operation group（n=105）and non-operation group（n=87）according to whether they had undergone cervical polypectomy during pregnancy,and their pregnancy and general situation outcome were compared.Secondly,according to the pregnancy outcome of pregnant women,the cases in the operation group were divided into spontaneous abortion group（gestational age<28 weeks,n=18）,premature delivery group(gestational age 28～36⁺⁶weeks,n=5)and full-term delivery group（gestational age≥37 weeks,n=82）to further clarify the relevant variables that affect the different pregnancy outcomes of the operation group.Collect the patient’s medical history information and relevant risk factors as the observation indicators by inquiring the medical records and telephone follow-up,and conduct statistical analysis of the above materials.The number of polyps,pregnancy,parity and other quantitative data showing non-normal distribution were statistically analyzed by Kruskal-Wallis H test.For the counting data such as cervical incompetence during pregnancy,vaginal bleeding after surgery,gestational diabetes mellitus and hypertensive disorders of pregnancy,χ²Test and Fisher Test were used for statistical analysis.Based on the results of the above signal factor analysis,the significant difference related variables affecting the pregnancy outcome in the operation group were screened out,and the multivariate logistic regression analysis was performed.At the same time,the OR（odds ratio）and 95%CI（confidence interval）were calculated.P value<0.05 indicates that the difference is statistically significant.Results:1.The proportion of cervical polyps found before pregnancy in the non-operation group and the operation group was 3.4%（3/87）and 14.3%（15/105）;The proportion of Vaginal discharge depuratory from degree III to degree IV during pregnancy,was 35.6%（31/87）and 53.3%（56/105）;The longest diameter of cervical polyps is 1.5 cm（1-2 cm）and 2.0 cm（1-3 cm）;The proportion of gestational diabetes mellitus was 22.6%（19/87）and 36.2%（38/105）,and the difference between the above four groups was statistically significant（χ²=6.577,8.407,9.328,5.489,P=0.010,0.038,0.002,0.019）.2.In the comparison of pregnancy outcomes between the non-operation group and the operation group,the proportion of premature delivery was 13.8%（12/87）and 4.8%（5/105）,which was statistically significant（χ²=4.809,P=0.028）.3.Compare the pregnancy outcomes among the operation group.The proportion of gestational age at the time of the operation≤12 weeks in the spontaneous abortion group（n=18）,premature delivery group（n=5）and full-term delivery group（n=82）was55.6%（10/18）,20.0%（1/5）and 18.3%（15/82）;The proportion of postoperative vaginal bleeding was 27.8%（5/18）,20.0%（1/5）and 4.9%（4/82）.The difference between the two groups was statistically significant（χ²=9.772,7.804,P=0.008,0.020）.4.The results of logistic regression analysis showed that vaginal bleeding after operation and operation at gestational age≤12 weeks were the risk factors of spontaneous abortion caused by cervical polypectomy during pregnancy（P=0.046,0.011,OR=4.778,4.374,95%CI:1.026～22.259,1.405～13.622）.Conclusion:According to previous research and clinical experience,our research center recommends that patients with cervical polyps found in pre pregnancy examination and persistent in pregnancy,leukorrhea in pregnancy routine prompts poor cleanliness（Ⅲ～Ⅳdegrees）,cervical polyps larger than 2cm,and gestational diabetes mellitus choose surgery to treat cervical polyps.Although the operation has no effect on spontaneous abortion,delivery mode,whether there is infection or premature rupture of membranes during delivery,but patients with conservative treatment should be alert to the risk of premature delivery during pregnancy.If patients choose surgical treatment,they should try to avoid cervical polypectomy before 12 weeks of pregnancy,pay attention to the exact hemostasis during the operation,and select the appropriate removal method according to the size and width of the polyp,so as to reduce the risk of spontaneous abortion after the operation.