Perinatal Outcomes in Women With Endocervical and Decidual Polyps During Pregnancy

Abstract

Although cervical polyps are benign, they may cause atypical symptoms such as vaginal bleeding, increased vaginal discharge, and localized infection. A recent study found that the detection of polyps in early pregnancy is a risk factor for preterm delivery before 28 weeks and at 34 and 37 weeks of gestation. Furthermore, cervical polyps are also are highly associated with cervical insufficiency (Hirayama et al., 2022). Another study found that the risk of preterm delivery before 37 weeks of gestation and spontaneous abortion are higher in pregnant women with decidual polyps than in those with endocervical ones (Tokunaka et al., 2015). A 2021 retrospective cohort study of 4,172 pregnant women included 92 patients diagnosed with cervical polyps before 12 weeks of gestation who had not undergone polypectomy. This study reported that the incidence of spontaneous preterm birth before 34 weeks of gestation was higher in pregnant women with cervical polyps than in those without them (5.4% vs. 0.7%, p<0.01). Furthermore, regression analysis revealed that cervical polyps are an independent risk factor for spontaneous preterm birth before 34 weeks of gestation, with an odds ratio of 4.09 (Wakimoto et al., 2022). Despite these findings, continued research on cervical polyps is required because studies on the effects of cervical polyps during pregnancy are limited, and their management remains controversial. Polyps observed in the cervix during pregnancy are benign gynecological neoplasms found in 2%-5% of women of child bearing age (Farrar & Nedoss, 1961; Younis et al., 2010). Cervical polyps can be asymptomatic during pregnancy but often cause repetitive vaginal bleeding. Moreover, they can cause preterm labor, infection, chorioamnionitis, and increased bleeding during labor (Golan et al., 1994; Wakimoto et al., 2022).