Before the end of pregnancy, the endometrium polyps, or not cut it?

This article was first published in Dr. Chunyu APP

The 26 -year -old 芊 took the pelvic ultrasound and asked me: Dr. Fu, ultrasound reported that I had endometrium polyps. I had no abnormal performance, and what was the polyps in the uterine endometrium?Will it impact pragnancy?Do you need to remove the endometrium polyps and then conceive first?

The ultrasound report tip: The endometrium high echo 1.2*1cm size, the endometrium polyps.

[What is the endometrium polyps?.

The endometrium polyps refer to the local endometrium gland and interstitial and the accompanying blood vessels to grow excessively. They enter the uterine cavity and are a kind of benign lesions in the uterine cavity in gynecological diseases.It can grow alone, or it can be permeated in the entire uterus to form endometrium polyps.

【Cause】

The cause is unclear, and estrogen stimulation is the main cause.

[Endometrial polyps and pregnancy epidemiology]

The incidence of infertility patients: 15.6%-32%.

Infertile patients with regular menstruation were tested by hysteroscopy and found that endometrial polyps were 15.6%.

The incidence of repeated abortion polyps was 15-50%.

Among patients who fail and repeated abortion, functional polyps and endometritis are the most common endometriosis.

【High -risk factors】

Dangerous factors: age, hypertension, obesity and hemosfen treatment.

Age: It seems to be the highest risk factor.The incidence of endometrial polyps grows with age.

Hypertension is another dangerous factor.

[Clinical manifestations]

A variety of performances: multiple or single hair; the size does not wait from a few millimeters to a few centimeters;

Different symptoms: No symptoms, or manifestations of abnormal bleeding, infertility and pelvic pain.

The symptoms are as follows:

One of the most common causes of abnormal uterine bleeding.

Extination rate of polyp bleeding: 68%.

It is manifested as: multiple menstrual passage, menstrual disorders, sexual intercourse, or bleeding between meridian.

Symptoms are not related to the size, quantity and location of polyps.

【diagnosis】

It can usually be found that the best examination time is to conduct vaginal ultrasound examination before the 10th day of the menstrual cycle; the diagnosis must be removed under hysteroscopy.

【Nature Return】

More than 25%polyps can be relieved naturally, especially <1cm small polyps (Level A)

The natural relief rate within 1 year reached 27%.

The diameter <1cm polyps are likely to be relieved naturally, and polyps with diameter> 1cm are likely to continue to exist and cause abnormal uterine bleeding.

[Dangerous factor of malignant changes in endometrium polyps]

Clinical symptoms: abnormal uterine bleeding, the highest risk of malignant is the endometrium polyps woman with symptoms after menopause.

The size of the polyp: diameter> 1.5cm.

Obesity, diabetes, hypertension.

He Moqifen increases the risk of typical hyperplasia and bad changes.

[Effect of endometrial polyps on pregnancy]

There is no significant impact on pregnancy with diameter at <1.5cm, but there are reports of increasing abortion rate.

The polyps with diameter at <2cm will not reduce the planting rate and pregnancy rate, but may increase the abortion rate.

The endometrium polyps on the ends of the palace have the greatest effect on pregnancy.

【treat】

Whether women with endometrial polyps need to treat symptoms, malignant risks and whether there are pregnancy needs.

Treatment is divided into conservative expectations, conservative surgery and radical surgery.

No fertility treatment

Regardless of menopause, symptomatic polyps should be removed.Can achieve the purpose of improving symptoms and clear diagnosis.

Asymptomatic polyps after menopause are unlikely to be malignant. It is expected that therapy can be discussed as a patient.With menstruation, endometrial polyps can shrink.

Treatment of fertility requirements

Patthrosis of infertile women can effectively improve the pregnancy rate.

If no other infertility is found except the polyps, it is worthy of polyps.

If the vaginal ultrasound checks the polyps> 2cm, it is recommended to remove the polyps from the hysteroscopy, and then try the pregnancy.

Natural pregnancy often occurs after polyps, indicating that polyps may affect the main factors of planting.Therefore, after hysteroscopy treatment, you can give three natural cycle test opportunities.

in addition,

Drug treatment is not recommended.So if you see the type of "how the endometrium polyps is treated, and the efficiency of 1 pill", don’t be deceived!

TCRP (endoscopic endoscopic endoscopycular polyps) is a gold standard for treatment.

For postmenopausal patients with symptoms, historians should be organized.

Therefore, for the asymptomatic endometrium polyps with a size of 1.2*1cm size, you can not deal with it temporarily. If you go home, you will naturally conceive. If infertility occurs, you can find infertility. At the same timePolycutics.

References: "Guidelines for Ocean Bleeding in 2014"

This article is an original article. The first published in the Chunyu APP. The picture comes from the Internet. The name of the article is changed. If you need to reprint, please contact the author of this article and Dr. Chunyu, WeChat Rainbow96_..

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