Polyp of the cervical canal during pregnancy: causes, diagnosis, treatment

04/22/2018 Category: Polyps Author: Pomiome

Article last updated 12/07/2019

A polyp of the cervical canal during pregnancy is a benign formation that forms on the mucous structures before or during pregnancy. In the absence of concomitant diseases of the reproductive system organs, it does not pose a threat to the health of the woman and the fetus. In most cases, treatment is not required if the symptomatic picture of the pathology is absent or mild.

What is it and why does it happen?

Decidual polyp of the cervical canal during pregnancy is a neoplasm, the appearance of which is provoked by pregnancy itself. The reason for the development of the growth is how exactly the mucous membrane reacts to the fertilized egg. Polyp of the cervical canal - is formed using the mucous membrane. It can appear at any time, regardless of whether a woman is pregnant or not. Both types of neoplasms have a common characteristic – they appear in the cervical canal.

The appearance of decidual polyps can be caused by the following factors:

serious changes in hormone levels;
diseases of the appendages and uterus, accompanied by the development of inflammatory processes;
weak immune system;
mechanical damage to the endometrium (abortion);
excessive production of estrogen;
infectious diseases acquired during sexual intercourse.

The most common reasons for the appearance of such formation is a lack of progesterone in combination with an excess of estrogen. However, the exact cause is currently unknown.

Main reasons

A polyp in the cervix during pregnancy is a rare occurrence. If such a pathology is diagnosed, conception becomes complicated and the risk of early miscarriage is high. Although polyposis is one of the most common gynecological diseases, the exact causes of its occurrence are still unknown.

It is believed that the formation of polyps can be triggered by factors such as:

chronic inflammatory processes in the cervix or in the organ cavity;
history of sexually transmitted infections;
pathologies in which the endometrium grows;
hormonal imbalances;
previous curettage;
pathological proliferation of blood vessels;
autoimmune diseases;
endocrine disorders;
hereditary predisposition.

Growths in the cervical canal can be caused by other reasons. Uncontrolled use of medications, excess weight and metabolic disorders contribute to the development of pathology. The tumor may appear as a result of an unsuccessful pregnancy, ending in miscarriage or death.

Long-term wearing of an intrauterine device changes the normal structure of endometrial tissue. A pregnancy that occurs soon may be complicated by the formation of polyps.

Symptoms

The following symptoms are typical for this type of polyp:

bleeding from the vagina;
bleeding that occurs after a vaginal examination or sexual intercourse;
aching pain in the lower abdomen.

If a girl discovers that she is bleeding from the vagina, she must immediately go to a specialist for timely diagnosis, identifying the cause of this condition and prescribing adequate therapy (if necessary).

Surgical intervention

Removal of a polyp is a drastic measure, which is resorted to in the following cases:

frequent and fairly heavy bleeding;
high risk of infection;
large size of the formation, which leads to the inability to give birth naturally.

The only way to remove a pathological formation with minimal risks for a pregnant woman is polypectomy . The operation can be performed at any stage, but preference is given to the second half of pregnancy, starting from 16-18 weeks. Depending on the size of the neoplasm, its soft structures are evaporated using a laser, or the method of cauterization with liquid nitrogen is used.

After the operation, the woman will have spotting for several weeks and aching pain in the lower abdomen, which is normal. If the polyp is large, and after its surgical removal there is a possibility of developing various complications, the woman is placed in a hospital under constant medical supervision.

After removal of the growth, the woman is prescribed supportive medical therapy, which includes taking painkillers and antispasmodics.

Opening of the cervical canal

An open cervical canal in any trimester of pregnancy is dangerous because it provokes miscarriage and premature labor. In most cases, when a formation is detected, experts recommend surgical measures, but the procedure is extremely dangerous for the fetus.

The cervical canal begins to open due to the development of the amniotic sac, which puts pressure on the cervix. The growth formed in the endometrium eventually penetrates deeply into the canal, causing it to open. An open canal in a pregnant woman is not a normal phenomenon, since it should be closed with a plug of mucous substance, which protects the uterus from the penetration of harmful bacteria and infections.

If the doctor diagnoses an opening of the canal, the patient is offered several treatment methods:

suturing the cervix;
a special uterine ring that does not allow opening.

What to do

If a polyp bleeds during pregnancy, you need to adjust your lifestyle. During hygienic procedures, limit yourself to ablution, reduce vital activity, refuse physical activity (you cannot lift more than 2.5-3 kg) and stop sexual intercourse.

The treatment method is suggested by the doctor, assessing the clinical picture. They try to postpone surgical intervention until the middle of the 2nd trimester - when the period exceeds 20 weeks, but in case of severe bleeding, a large tumor, or in emergency cases, urgent operations are performed. Methods of surgical intervention - hysteroscopy or pulling the leg of the polyp with a tourniquet. A pregnant woman is recommended to remain under the supervision of a doctor in the hospital for 1-2 weeks after surgery to ensure that medical procedures do not affect the general condition.

Conservative treatment of polyposis:

To suppress the growth of tumors, Duphaston, a drug with progesterone, is prescribed.
Antibacterial agents are used to prevent infection. Preference is given to systemic medications in the form of suppositories or vaginal tablets.

In some cases, patients are recommended to undergo outpatient treatment - visiting the hospital to insert tampons with hemostatic agents to stop bleeding.

Planned conception and removal of the polyp do not guarantee recurrence of the pathology. If a woman has a tendency to polyposis, she is put under special control. During pregnancy, it is recommended to monitor weight gain so as not to provoke endocrine disruption, and to avoid unprotected coitus. Vaginal dysbiosis stimulates the growth of tumors.

Do I need treatment?

Polyps that a doctor can detect during a gynecological examination are not dangerous. They are characterized by independent resorption at certain stages of pregnancy. They can also come out during childbirth. If a cesarean section had to be performed, the patient must be offered a surgical method to remove the formation.

To accurately determine whether treatment is necessary, the patient must undergo smears from the cervical canal. The test results will help determine whether a tumor is benign or malignant. If it does not threaten the health of the mother and fetus, no treatment will be required.

Diagnosis of the disease

Polyposis can only be detected after visiting a doctor. Diagnosis of deciduosis includes the following procedures:

examination of the cervix in a gynecological chair using vaginal speculum;
cytology;
colposcopy during pregnancy;
biopsy;
Ultrasound.

Examination of the cervical canal during pregnancy to identify a polyp allows you to see a protruding neoplasm. At this stage, it is impossible to determine the type of growth; further examination is required.

The protrusion can be pinkish, purple or brownish in appearance. The examination allows you to make a preliminary diagnosis.

Cytological examination for diseases of the uterus allows you to determine what type of growth has formed. Laboratory analysis will show whether it is a benign polyp or a malignant neoplasm.

If necessary, after a gynecological examination, the doctor will perform a colposcopy. This is a procedure that does not require anesthesia. It is not dangerous for the child and painless for the woman. During the examination, you can see the formation and the entire cervix under multiple magnification.

A biopsy in pregnant women is performed only if there are serious indications. The reason for this procedure is frequent bleeding or strong suspicion of cancer.

Carrying out an ultrasound to detect the formation of cervical tumors is not always justified. Polyps can only be seen in early pregnancy. Not all types of growths are visualized during such an examination.

In what cases is a polyp dangerous and why?

If the growth becomes infected during pregnancy, the woman should undergo antibacterial therapy.

Neoplasms are especially dangerous for women who want but cannot get pregnant - they do not allow seminal fluid to pass through, preventing fertilization.

A polyp can provoke isthmic-cervical insufficiency - premature birth begins, as a result of which a child is born with poorly developed internal organs and systems, underweight, which often causes the death of the newborn.

Quite often, doctors recommend surgical methods for treating growths, but surgery can be more dangerous for the developing embryo than the tumor itself.

When can you get pregnant after removal of a polyp in the uterus?

Hysteroscopic intervention (removal of the polyp) will require post-hormonal therapy to ensure that the disease does not recur. The effect of some hormones is cumulative, and therefore treatment is prescribed for at least 3 months.

Surgery to remove polyps in the uterus increases the chances of bearing a healthy child in the future.

How long will it take

It will take at least 6 months for the body to recover after surgical treatment.

During this period, hormonal therapy, a vitamin complex and special procedures are prescribed that help strengthen the body's strength.

How long after removal is possible?

Gynecologists recommend planning conception after the intervention no earlier than 4 months later. Ideally, after complete recovery - in six months, a year. During this time, the woman undergoes both moral and physiological recovery.

There is an opinion that growths in the reproductive organ diverge during pregnancy and then come out along with the child’s place without the need for surgical intervention. However, it is impossible to make a decision about conception without consultation, because the etiology of the disease can be infectious, which jeopardizes the likelihood of a successful pregnancy outcome.

Possible complications

The growth of the polyp is likely to progress, and the possibility of degeneration of benign tumors into malignant tumors remains. Therefore, a woman should pay attention to the following symptoms:

pain in the lower abdomen;
bleeding or unusual discharge in the middle of the cycle;
nagging pain in the lower back;
yellowish or greenish discharge from the vagina;
slight changes in body temperature.

During pregnancy, removal surgery is not performed, but is postponed until the postpartum period.

Treatment

The only treatment for cervical canal polyps is surgical treatment. To undergo surgery, a woman must have the following symptoms:

the formation exceeds 15 mm in size;
there is excessive growth of the tumor;
polyp necrosis;
the appearance of symptoms of dyskaryosis.

Surgical removal of the growth occurs by scraping the mucous membrane. There are more gentle methods of surgical therapy (removal with laser, electrical impulses and radio waves), but they are not used in all medical institutions due to the lack of necessary equipment.

After surgical treatment, the woman will have to undergo hormonal therapy, which is contraindicated during pregnancy.

Treatment during pregnancy

Surgical removal of the tumor is not always performed. If the polyp does not cause pain or discomfort to the woman during sexual intercourse, does not increase in size and does not transform into a cancerous tumor, treatment is postponed until the postpartum period.

Pregnancy can proceed normally, and the neoplasm does not affect the birth process. Some types of polyps leave the woman's body with the child. In other cases, hormones and, if necessary, antibiotics are prescribed.

Removal of a polyp during pregnancy by surgical intervention is indicated in the following cases:

the growth exceeds 1 cm;
increases by more than 2 mm per month;
the neoplasm develops new processes;
high risk of fetal infection;
frequent heavy bleeding occurs.

Surgical therapy is performed only on the cervical area. Intervention in the uterine cavity leads to the death of the embryo. The operation is done using a hysteroscope. The cervical canal is opened slightly and excision is performed.

Is it possible to get pregnant with a cervical canal polyp?

Quite often, women wonder whether it is possible to get pregnant with a polyp? Typically, such a formation interferes with conception because it does not allow seminal fluid to reach the egg. However, it happens that a woman becomes pregnant despite the presence of a polyp. It all depends on the location and activity of the formation. An underdeveloped passive polyp in the cervical canal does not have a negative effect. However, if it is detected, the woman must undergo special therapy, since such a growth contributes to the penetration of infections.

A woman with such education can become pregnant, but it is better to ensure healthy, safe development of the embryo. The growth can progress and lead to the development of other problems, such as premature birth.

Probability of conception

Many women are interested in whether pregnancy is possible if they have a cervical canal polyp. Doctors answer that it all depends on the size of the formation. With a small polyp, there are usually no difficulties with conception. But in the future there is a risk of infection, so if it is detected before pregnancy, you need to undergo appropriate treatment or resort to surgical intervention.

Is it possible to get pregnant with a large neoplasm of the cervical canal? If the tumor reaches 5 cm or more, it interferes with conception, since sperm will not be able to penetrate the egg, so it must be removed.

Although a small cervical polyp during pregnancy does not pose a threat to the pregnant woman and the fetus, it can provoke a number of complications in the presence of concomitant diseases of the reproductive system. Therefore, before conceiving a child, it is recommended to undergo a thorough medical examination. With the constant growth of benign formations, there is a threat of premature birth.

Conception after removal

Pregnancy after removal of a polyp of the cervical canal is possible, since the neoplasm does not interfere with the fertilization of the egg. It is necessary to remove the growth before or after pregnancy, since doctors will have to use anesthesia, which, together with other factors, can harm the development of the fetus.

After removal of the tumor, a woman can immediately become pregnant, but it should be remembered that pregnancy can cause the development of a new growth due to hormonal imbalance. Therefore, the expectant mother needs to constantly undergo examination by a gynecologist to timely detect and eliminate the problem.

Such a neoplasm in the cervical canal as a polyp during pregnancy is not always a threat. In most cases, you just need to observe it. It is necessary to remove a polyp only in critical situations when it threatens the life of the unborn child.

Possible threat to the fetus

For the most part, polypous formation on the cervical canal during pregnancy does not cause the woman any particular inconvenience and does not in any way affect the normal development of the child, but this only applies to those cases where there are no complications. If the presence of a benign neoplasm on the cervix is accompanied by frequent bleeding and abdominal pain, the woman is admitted to the hospital “for preservation.”

In the presence of concomitant diseases of the reproductive system organs, there is a risk of infection, which can affect the soft structures of the polyp. In this case, there is a risk that the infection will penetrate through the placenta to the fetus. This probability is small, but not excluded. If there is a threat of infection, the formation is immediately removed.