目的

探讨孕期采取宫颈息肉摘除术对孕妇妊娠结局影响，以及妊娠合并宫颈息肉孕妇的妊娠结局影响因素。

方法

选择2019年1月至2022年12月于首都医科大学附属北京安贞医院进行定期产前检查的97例妊娠合并宫颈息肉孕妇为研究对象。采取回顾性分析方法，根据孕期是否采取宫颈息肉摘除术，将其分为手术组（n=25，采取宫颈息肉摘除术）及未手术组（n=72，未采取宫颈息肉摘除术）。采用独立样本t检验、χ² 检验及Mann-Whitney U 检验，对2组孕妇的一般临床资料及妊娠结局相关临床资料进行统计学分析。采用多因素非条件logistic回归分析法，对影响2组妊娠合并宫颈息肉孕妇妊娠结局的影响因素分别进行分析。本研究经本院伦理委员会批准（审批文号：2024218x），所有孕妇对诊治方案知情同意。

结果

①手术组孕妇术前阴道流血率、阴道流血者流血时长及宫颈息肉直径（最长径）分别为76.0%，7.00 d（0.25，30.00 d）、2.5 cm（1.9，3.0 cm），均高于、长于及大于未手术组的26.4%，0 d（0，0.50 d），1.0 cm（0.5，1.4 cm），并且差异均有统计学意义（χ²=19.17、P＜0.001，Z=-5.15、P＜0.001，Z=-4.58、P＜0.001）。②2组孕妇自然流产率、早产率、足月产率、剖宫产率、未足月胎膜早破率及新生儿出生体重比较，差异均无统计学意义（P＞0.05）。③手术组宫颈息肉与宫颈蜕膜息肉孕妇术后阴道流血率、自然流产率、早产率、足月产率及未足月胎膜早破率比较，差异均无统计学意义（P＞0.05）。④未手术组妊娠合并宫颈息肉孕妇阴道流血（OR=9.836，95% CI：1.948～49.659，P=0.006）是影响其足月妊娠的独立危险因素；未发现手术组妊娠合并宫颈息肉孕妇妊娠结局的独立影响因素。

结论

孕期宫颈息肉摘除术并不增加妊娠合并宫颈息肉孕妇流产和早产风险。对于有阴道流血症状者，孕期未接受宫颈息肉摘除，可能影响其足月妊娠。

Objective

To explore the influence of cervical polypectomy during pregnancy on the pregnancy outcome of pregnant women，and the influencing factors of pregnancy outcome of pregnant women with cervical polyps.

Methods

A total of 97 pregnant women with cervical polyps who underwent regular prenatal examination in Beijing Anzhen Hospital affiliated to Capital Medical University from January 2019 to December 2022 were selected as the study objects.The clinical data were analyzed retrospectively.According to whether cervical polypectomy was performed during pregnancy or not，they were divided into operation group （n=25，accept cervical polypectomy）and non-operation group （n =72，not accept cervical polypectomy）.Independent-samples t test，chi-square test and Mann-Whitney U test were used to compare the general clinical data and the clinical data related to pregnancy outcome between two groups.Multivariate logistic regression analysis was used to analyze the influencing factors on the pregnancy outcome of pregnant women with cervical polyps in two groups.This study was approved by the Ethics Committee of our hospital （Approval No.2024218x），and all pregnant women gave informed consent to diagnosis and treatment.

Results

①The rate of preoperative vaginal bleeding，the bleeding duration of vaginal bleeding and the longest diameter of cervical polyps in operation group were 76.0%，7.00 d （0.25，30.00 d）and 2.5 cm（1.9，3.0 cm），respectively，which were higher，longer and larger than those of 26.4%，0 d（0，0.50 d）and 1.0 cm（0.5，1.4 cm）in non-operation group，and the differences were statistically significant （χ²=19.17，P＜0.001；Z=-5.15，P＜0.001；Z=-4.58，P＜0.001）.②There were no significant differences in spontaneous abortion rate，preterm birth rate，full-term birth rate，cesarean section rate，preterm membranes premature rupture rate and neonatal birth weight between 2 groups （P＞0.05）.③There were no significant differences in the incidence of postoperative vaginal bleeding，spontaneous abortion，premature delivery，full-term delivery and premature rupture of membranes between cervical polyps and cervical decidual polyps pregnant women in operation group（P＞0.05）.④Vaginal bleeding of pregnant women with cervical polyps （OR=9.836，95% CI：1.948-49.659，P=0.006）was an independent risk factor for full-term pregnancy in non-operation group.No independent influencing factors were found for pregnancy outcomes in operation group.

Conclusions

Cervical polypectomy during pregnancy does not increase the risk of miscarriage and premature delivery in pregnant women with cervical polyps.For those with vaginal bleeding symptoms and cervical polyps enucleation were not performed during pregnancy，may affect their full-term pregnancy.