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Persistence and Characterization of Vaginal Granul ...
Persistence and Characterization of Vaginal Granulation Tissue in the Postpartum Period - Daniel D Lee, MD
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This retrospective cohort study aimed to determine the incidence of persistent vaginal granulation tissue/polyps in the postpartum period and explore associated risk factors. A total of 80 women were included, and 66% had persistent granulation tissue at 6 weeks postpartum. The majority of the tissue (75%) was located in the midline of the vagina. In terms of management, 53% were observed, 21% received in-office silver nitrate, 21% underwent surgical excision, and 5% required surgical excision after silver nitrate treatment. Granulation tissue that required intervention had a median length of 15mm, while non-intervened tissue had a median length of 5mm. The median time from delivery to surgical excision was 174 days.<br /><br />Several factors were found to be associated with persistent granulation tissue. Women with persistent tissue had a longer second stage of labor and were more likely to be breastfeeding. They were also more likely to experience vaginal pain after delivery. Other demographic, intrapartum, and postpartum variables did not show associations with persistent granulation tissue.<br /><br />The study concludes that persistent vaginal granulation tissue is a common and painful condition that may require office-based or surgical management in the postpartum period. The findings suggest the importance of identifying risk factors and developing appropriate management strategies for this condition.<br /><br />The provided table compares women with and without persistent granulation tissue at 6 weeks postpartum, showing no significant differences in age, body mass index, baby weight, parity, tobacco use, Group B Streptococcus status, chorioamnionitis, antibiotics during labor, total time of ruptured membranes, total labor time, vacuum/forceps-assisted delivery, episiotomy, estimated blood loss, antibiotics at repair, suture type, wound infection, wound dehiscence, or OASIS/sulcal injury. However, there were significant differences in second stage time, postpartum hematoma, pain, and breastfeeding between the two groups.
Keywords
retrospective cohort study
persistent vaginal granulation tissue
postpartum period
risk factors
management
silver nitrate
surgical excision
delivery
breastfeeding
vaginal pain
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