Symptoms, Causes and Treatment of Pyogenic Granuloma during Pregnancy

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Pyogenic granuloma is a benign vascular lesion of the mucosa and skin, and scientific research is yet to identify its definitive causes. While lesions may occur in several places such as on the head, neck, upper trunk, and extremities of children and young adults; it also often emerges during a woman’s pregnancy period.

Pyogenic granuloma during pregnancy, the form considered as a pregnancy tumor because of its emergence in the mouth area, often develops on the gingiva or in other sites of the oral mucosa. However, lesions may also appear simultaneously in other parts of the body, along with the oral pregnancy tumor. Treatment methods may include surgical removal, lasers, and dental care; but smaller pregnancy tumors often subside after childbirth prior to the urgent need for removal.

Causes and Symptoms

Around 2 to 10 percent of pregnant women reportedly develop pyogenic granuloma in pregnancy. The vascular lesions are not tumors and are generally harmless. However, women opt for removal if too much discomfort in eating and talking occurs, and if the lesion becomes too vulnerable to bleeding.

Pregnancy tumor is a mouth-based disease characterized by the emergence of inflamed tissue outgrowth, which usually arises during the pregnant women’s second trimester. The exact cause of pregnancy granulomas are yet to be clearly established, as in any form of pyogenic granuloma. However, exhibiting poor oral hygiene is associated as one of the primary risk factors, and other possible factors are believed to include hormones, trauma, viruses, malformed blood vessels, viral oncogenes, and microscopic arteriovenous malformations. Furthermore, those who develop the said vascular lesion growths usually suffer from pregnancy gingivitis. Consumption of oral contraceptives is also linked to the formation of pregnancy granuloma or pyogenic granuloma.

The oral disease starts to emerge as a form of overgrown tissue in the mouth area. It manifests as a vascular granulation or a purple or red lesion, and often coupled with soreness in the region. Its size may range from a meagre millimeter to few centimetres. Other symptoms include profuse ulceration, crusting, rapid growth and bleeding, regardless of the presence or absence of trauma.

Common Treatment Options

Pyogenic granuloma in a pregnant woman is inclined to dry up, heal on its own, and disappear after childbirth. If excision or surgical removal is employed, re-emergence may occur after removal or during the next pregnancy.

Conservative Surgery and Supplementary Measures

Conservative surgical excision is one of the conventional ways of treating pregnancy tumors, along with the simultaneous removal of potentially infectious or traumatic factors. If surgical excision should be used, it is best carried out after childbirth; however, certain situations may warrant urgent removal prior to delivery, such as when the granuloma bleeds excessively or causes pain. In such cases, the best time for surgical removal would be during the second trimester, so as to reduce risks of causing detriments to the fetus.

Recorded figures show that recurrence takes place in around 15% of removed lesions, and the next formations exhibit higher recurrence rate. As such, excision should also be coupled with scaling, scraping and burning— curetting the surgical wound bed and scaling the adjacent teeth.

Laser Surgery

Laser treatment’s effects are optimized when the method is used after a conservative surgical removal of the lesion’s hypertrophy components. The success of laser surgery is also heightened if employed at the benign lesion’s early state, along with the aid of diascopy.

Dental care and cleaning

There are certain incidences of pyogenic granuloma during pregnancy that can be removed through dental care—an effective means of inhibiting the cause of lesion-growth. Case in point: Tartar aggravates gum irritation, which in turn enables pyogenic granuloma’s development during pregnancy. If the cause is substantially linked to tartar abundance, cleaning off the tartar can significantly treat the pregnancy tumor.