Abstract
OBJECTIVE: This study aimed to assess the safety of vaginoscopic polypectomy for managing cervical polyps during pregnancy and to identify factors influencing postoperative obstetric outcomes. METHODS: We conducted a retrospective analysis of 99 pregnant patients who underwent vaginoscopic polypectomy for cervical polyps at Beijing Tiantan Hospital between January 2017 and February 2025. Based on pregnancy outcomes, patients were categorized into three groups: term delivery (n = 88), preterm delivery (n = 6), and spontaneous abortion (n = 5). Clinical characteristics were compared, and risk factors associated with pregnancy outcomes were analyzed. Patients were also classified into the cervical polyp group (n = 67) and the cervical decidual polyp group (n = 32) based on pathological diagnosis for further comparison of clinical features and prognosis. RESULTS: All cervical polyps were resected successfully in a single procedure without any perioperative complications during pregnancy. The rates of term delivery, preterm delivery, and spontaneous abortion were 88.88% (88/99), 6.06% (6/99), and 5.05% (5/99), respectively. Preoperative vaginitis and postoperative recurrent bleeding differed significantly among the outcome groups (both p < 0.001) and were significantly associated with adverse pregnancy outcomes. Compared with the cervical polyp group, the decidual polyp group had a significantly greater polyp width, an earlier gestational age at diagnosis, and a higher rate of postoperative bleeding (p = 0.005, 0.013, and 0.036, respectively). However, the incidence of adverse pregnancy outcomes (preterm delivery and abortion) did not differ significantly between the two pathological groups (p > 0.05). CONCLUSION: In this observational clinical study, vaginoscopic polypectomy appeared to be a feasible and well-tolerated intervention for symptomatic cervical polyps during pregnancy. Preoperative vaginitis and postoperative rebleeding were identified as key factors associated with adverse obstetric outcomes. These findings highlight the importance of rigorous perioperative infection control and the prompt management of bleeding in this specific population. Further large-scale, prospective, controlled studies are warranted to confirm the procedure's therapeutic effect and to validate the factors identified in this analysis.