摘要
A 29-years-old primiparous woman,presented at 9 weeks 2 days pregnant due to moderate vaginal bleeding with neoplasm prolapsed from vagina for two days.She have suffered from recurrent vaginal spotting for about 4 weeks,and took dydrogesterone more than 3 weeks following the doctor's instructions at the local hospital.She had diagnosed as an endometrial polyp of about 1.3×0.6 cm in size by ultrasound scan before pregnancy.At present,the color doppler ultrasound revealed that a giant decidual polyp occupied the whole cervix canal,with wide pedicle base arised from the middle and lower part of the uterine cavity,and the lower part prolapsed the outside of cervix.After hospital admission,the speculum examination showed that a dark purple neoplasm with a size of about 5×3×3cm in the vagina protruding out of the cervical canal,on which surface there was a spontaneous bleeding point.The blood test findings included a WBC count of 8.59×910/L and C-reactive protein level of 3.02ng/L.Her temperature was 36.2℃.Cefuroxime was given to prevent infection after admission.Compression was given to stop bleeding,but there was still active bleeding on the surface of the polyp the next day.Therefore,a ultrasound-guided torsion polypectomy was performed in emergency.In the therter,we twisted the neoplastic tissues by oval forceps taking a step-by-step approach,until 1cm above the outsise of cervix.At this point,ultrasound scan showed that the pregnant sac was obviously pulled by external forces.So,we stop the polypectomy,leaving a small portion of the giant polyp.Ceftrixone sodium and dydrogesterone were given after the operation and a small amount of vaginal bleeding lasted for 6 days without obvious abdominal pain.A medium to strong echo of about 1.7×0.6×0.9cm in the cervical canal was showed by color doppler ultrasound,which continued upward to the upper part of the cervical os.Histopathological examination revealed a decidual polyp.The patient had no abdominal pain and vaginal bleeding during pregnancy.She had a premature rupture of membranes and gave birth to a baby with the weight of 3300g through vaginal at 37 weeks and 1 day of gestation.
