To explore pregnancy outcomes and influencing factors of pregnant women undergoing cervical polypectomy during the first and second trimester.

From January 2012 to April 2018, a total of 167 pregnant women with single-pregnancy who were operated by cervical polypectomy during first and second trimester in Shengjing Hospital of China Medical University were collected in this study. According to pregnancy outcomes, they were divided into 3 groups: miscarriage group (gestational age at termination of pregnancy < 28 gestational weeks, n=17), premature group (gestational age at termination of pregnancy was 28-36^{+ 6} gestational weeks, n=48) and full-term group (gestational age at termination of pregnancy ≥37 gestational weeks, n=102). The Kruskal-Wallis H rank sum test or Mann-Whitney U rank sum test were used to carry out statistical analysis on the quantitative data such as age, pregnancy and parity. Linear trend chi-square test or chi-square test were used to statistically analyze the counting data, such as the proportion of patients with cervical conization history, gestational diabetes mellitus, pregnancy-induced hypertension and preoperative vaginal bleeding. On the basis of the above single factor analysis, according to previous research results and clinical experience, further orderly multi-classification unconditional logistic regression analysis was carried out to analyze the relevant factors that may affect the pregnancy outcomes of patients after cervical polypectomy during the first and second trimester. This study was in line with the requirements of World Medical Association Declaration of Helsinki revised in 2013. All participants confirmed and signed consent forms for clinical trials.

① There were 0 (0-0), 0 (0-1) and 0 (0-0) parity in miscarriage group, preterm group and full-term group, respectively. The gestational age at the time of operation was 13 weeks (12-14 weeks), 15 weeks (13-17 weeks) and 15 weeks (13-18 weeks), respectively. The proportion of vaginal bleeding after operation was 35.3% (6/167), 50.0% (24/167) and 48.0% (49/167), and the proportion of gestational age ≤ 12 weeks at the time of operation was 23.5% (4/167), 10.4% (5/167) and 5.9% (6/167), respectively. The differences among the above four indexes were statistically significant (χ² =7.363, 7.535, 9.198, 4.364; P=0.025, 0.023, 0.002, 0.037). ② Combined with the existing research results and clinical experience, as well as the factors with statistically significant difference in single factor analysis results (P< 0.05), the orderly multivariate unconditional logistic regression analysis was conducted. The results showed that no vaginal bleeding after polypectomy was the protective factor for full-term delivery (OR=13.577, 95%CI: 1.300-141.743, P=0.029). ③The rate of spontaneous abortion in third trimester was 37.3% and 76.5% in patients with cervical polyp and decidual polyp, and the rate of patients with polyp inflammation was 52.7% and 0, respectively. The differences were statistically significant (χ²=9.646, 16.991, P=0.002, <0.001).

Cervical polypectomy in pregnancy should be avoided before 12 gestational weeks and hemostasis measures should be taken during operation. However, patients with cervical decidual polyps are more likely to have spontaneous miscarriage in third trimester than those with cervical polyps.