安徽医科大学学报

目的 比较不同妊娠方式妊娠期宫颈息肉摘除术后的妊娠结局。方法 收集入院行妊娠期宫颈息肉摘除术的孕妇125例。按妊娠方式不同分为自然妊娠组(n=71例),体外受精-胚胎移植组(IVF-ET组，n=54例),回顾性分析孕妇年龄、怀孕孕次、生产产次、流产次数、不良妊娠史、子宫内膜息肉史、发现宫颈息肉前是否有阴道流血、宫颈息肉摘除时的孕周、息肉数目、术后病理学检查及妊娠结局等临床资料。结果 妊娠期宫颈息肉最常出现的症状是异常阴道流血，共有111例，约占88.8%(自然妊娠组有62例，发生率87.32%,IVF-ET组有49例，发生率为90.74%);部分患者出现分泌物增多或妇科检查时发现，共占11.2%。本研究所有患者均行宫颈息肉摘除，手术后13例发生流产(自然妊娠组7例，IVF组6例),10例早产(自然妊娠组6例，IVF组4例),93例孕足月分娩，约占74.4%(自然妊娠组54例，IVF组=39例),9例妊娠中(自然妊娠组4例，IVF-ET组5例);术后病理：炎性息肉105例，占84%,蜕膜息肉20例，占8%(自然妊娠组和IVF-ET组各10例，发生率分别为14.09%和18.52%)。IVF-ET组术前阴道流血发生率、蜕膜息肉发生率、术后流产及术后早产发生率均高于自然妊娠组，但差异无统计学意义。结论 自然妊娠组患者和IVF-ET组患者行妊娠期宫颈息肉摘除术，两组患者的妊娠结局无明显差别。

Objective To compare pregnancy outcomes among pregnant women undergoing cervical polypectomy during different gestational periods. Methods A total of 125 pregnant women were diagnosed with cervical polyps and underwent surgical removal. These participants were divided into the natural pregnancy group(n=71) and the in vitro fertilization and embryo transfer group(IVF-ET group, n=54). Retrospective analysis was conducted on various clinical parameters including age, gestational times, delivery times, abortion times, history of adverse pregnancy outcomes, history of endometrial polyps, pre-polyp removal vaginal bleeding episodes, gestational age at the time of polyp removal procedure, number of polyps detected during surgery, postoperative pathology results as well as pregnancy outcomes. Results Vaginal bleeding was the most common symptom of pregnancy combined with cervical polyps, accounting for 111 cases(88.8%)(62 cases in the natural pregnancy group(87.32%) and 49 cases in the IVF-ET group(90.74%)). Some patients had increased vaginal discharge or were found during a gynecological exam, accounting for 11.2% of the patients. All patients underwent cervical polypectomy during pregnancy, except for 9 cases of continued pregnancy(4 cases in the natural pregnancy group and 5 cases in the IVF-ET group), of which 13 had miscarriage, 10 had preterm birth(6 in the natural pregnancy group and 4 in the IVF group)and 93(54 cases in natural pregnancy group, 39 cases in IVF group)(74.4%) delivered at full term. Postoperative pathology was mostly inflammatory polyps(105 cases, 84%), deciduous polyps(20 cases, 8%)(10 cases in the natural pregnancy group and 10 cases in the IVF-ET group, 14.09% and 18.52%, respectively). The incidence of preoperative vaginal bleeding, decidual polyp, postoperative abortion, and postoperative preterm birth in the IVF-ET group exhibited higher rates compared to those observed in the natural pregnancy group; however, these differences did not reach statistical significance. Conclusion The cervical polypectomy procedure was performed during pregnancy for both the natural conception group and the IVF-ET group, with no significant disparity observed in pregnancy outcomes between these two cohorts.