title: Decidual polyps are associated with preterm delivery in cases of attempted uterine cervical polypectomy during the first and second trimester.
abstract: OBJECTIVE
  To clarify which types of cervical polyp removed during the first and second trimester are associated with the risk of spontaneous abortion and preterm delivery.
  
  
  METHODS
  Pregnant females who underwent attempted polypectomy of cervical polyps during pregnancy and delivered singleton infants between 2005 and 2011 were evaluated. The clinical courses and outcomes of preterm delivery after polypectomy stratified according to the pathologic diagnosis of the polyps were retrospectively reviewed. The removed polyps were classified into decidual polyps and endocervical polyps.
  
  
  RESULTS
  The pathological diagnoses included 41 decidual polyps and 42 endocervical polyps. No malignant polyps were found. The removal of decidual polyps during pregnancy carried a higher risk of spontaneous abortion (12.2% versus 0%, p = 0.026) and preterm delivery (34.2% versus 4.8%, p = 0.001) than that of endocervical polyps. According to the multivariate logistic regression analysis, risk factors for preterm delivery before 37 weeks' gestation were the presence of decidual polyps and a history of preterm delivery.
  
  
  CONCLUSIONS
  The risk of abortion and preterm delivery associated with polypectomy during pregnancy is greater in patients with decidual polyps. It might be safer not to remove cervical polyps during pregnancy, except in cases in which the polyps are suspected to be malignant.
authors.affiliation: Department of Obstetrics and Gynecology, Showa University School of Medicine , Tokyo , Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Tokunaka
authors.forename: Junichi
authors.initials: J
authors.lastname: Hasegawa
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Oba
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Nakamura
authors.forename: Ryu
authors.initials: R
authors.lastname: Matsuoka
authors.forename: Kiyotake
authors.initials: K
authors.lastname: Ichizuka
authors.forename: Katsufumi
authors.initials: K
authors.lastname: Otsuki
authors.forename: Takashi
authors.initials: T
authors.lastname: Okai
authors.forename: Akihiko
authors.initials: A
authors.lastname: Sekizawa
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002584:Cervix Uteri / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D011127:Polyps / Q000473:pathology* / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology*; D011247:Pregnancy; D047928:Premature Birth / Q000209:etiology*; D002577:Uterine Cervical Diseases / Q000473:pathology* / Q000601:surgery
keywords: Abortion; cervical polyp; decidual polyp; polypectomy; preterm delivery