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妊娠期阴道内镜宫颈息肉切除术与妊娠结局分析

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目的 探讨妊娠期阴道内镜宫颈息肉切除术后不良妊娠结局的影响因素。方法 回顾性分析2017年4月至2023年7月首都医科大学附属北京天坛医院妊娠合并宫颈息肉伴有反复阴道流血,并接受阴道内镜宫颈息肉切除术52例患者的临床资料,分为蜕膜息肉组(15例)和宫颈息肉组(37例)。结果 52例患者中,蜕膜息肉组手术的孕周及分娩孕周明显早于宫颈息肉组(P<0。05),蜕膜息肉组术后的阴道流血率(26。67%)、自然流产率(26。67%)、早产率(26。67%)及胎膜早破率(33。33%)明显高于宫颈息肉组术后的阴道流血率(5。40%)、自然流产率(0)、早产率(5。40%)及胎膜早破率(16。22%),差异有明显统计学意义(P<0。05)。两组患者的分娩方式及新生儿结局比较,差异均无明显统计学意义(P>0。05)。回归分析结果显示,术后病理为蜕膜息肉及术后阴道流血率是早产的危险因素(P<0。05)。结论 与妊娠期宫颈息肉相比,蜕膜息肉术后更容易发生不良的产科结局,蜕膜息肉及术后再次阴道流血是发生早产的高危因素。
Pregnancy outcomes of vaginoscopy technique for cervical polypectomy in pregnant patients
Objective To investigate pregnancy outcomes of vaginoscopy technique for cervical polypectomy in pregnant women.Analysis of the influencing factors of adverse perinatal outcomes after cervical polypectomy.Methods We performed a retrospective analysis of 52 pregnant with cervical polyps accompanied with vaginal bleeding,all the patients underwent cervical polypectomy by vaginoscopy technique from April 2017 to July 2023.Results According to the pathological diagnosis of the polyp specimen,the patients were assigned to the cervical polyp group and the cervical decidual polyp group,and the clinical features of the two groups were compared and analyzed.The cervical polypectomy was performed significantly earlier in the decidual polyp group than cervical polyp(P<0.05).The gestational week of delivery was earlier in the decidual polyp group than the cervical polyp(P<0.05).The incidence of vaginal bleeding post-operation(26.67%),spontaneous abortion(26.67%),preterm birth(26.67%),rupture of membranes(33.33%)in decidual polyp group was higher than the incidence of vaginal bleeding post-operation(5.40%),spontaneous abortion(0),preterm birth(5.40%),rupture of membranes(16.22%)in cervical polyp(P<0.05).There was no difference in the mode of delivery and neonatal outcomes in both groups.The logistic regression analysis found that decidual polyp and vaginal bleeding post-operation were risk factors for preterm birth.Conclusions Compared with cervical polyps during pregnancy,decidual polyps are more likely to be associated with adverse obstetrics outcomes.Cervical decidual polyps and postoperative vaginal bleeding increase the risk of preterm birth.

vaginoscopycervical polyp in pregnancydecidual polypscervical polypectomypreterm birth

张露平、张生澎、郭蕾、边茜、李晶华、冯力民

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首都医科大学附属北京天坛医院妇产科,北京 100070

阴道内镜 妊娠期宫颈息肉 蜕膜息肉 宫颈息肉切除术 早产

2024

中国妇产科临床杂志
北京大学

中国妇产科临床杂志

CSTPCD北大核心
影响因子:1.095
ISSN:1672-1861
年,卷(期):2024.25(6)