Page 98 - FINAL COMPENDIUM 2020-2021 27.2.2022

PREGNANCY-ASSOCIATED PYOGENIC GRANULOMA : A CASE REPORT

Mohd Suhaimi AA, Sockalingam G

Introduction: Pyogenic granuloma is a fast growing reactive proliferation of endothelial
cells which appears as an overgrowth of tissue in response to various stimuli such as low-
grade local irritations, traumatic injuries or hormonal factors. Pyogenic granuloma
commonly occurs during pregnancy and is thought to be related to the vascular effects of
the female hormones, thus termed as “Pregnancy Tumour”. Case report: A 13-year-old
girl, at 38 weeks pregnancy presented with right lower gum swelling which gradually
increased in size and was associated with bleeding. Intraoral examination revealed a
bilobulated pedunculated vascular swelling from gingiva at interdental area between
tooth 42 and 43. Based on history and clinical features, a diagnosis of pyogenic granuloma
was made. Upon discussion with the Obstetrics & Gynaecology team, excisional biopsy of
the lesion was planned after the parturition. Later, excisional biopsy was done under local
anaesthesia using electrocautery followed by construction of splint with periodontal
dressing issued on the same day. The histopathological examination confirmed as
pyogenic granuloma. Review at 1 year post-excision revealed no recurrence. Discussion:
Pyogenic granuloma in children is usually due to local irritation such as accumulation of
calculus, sharp edges of broken down teeth or mobile deciduous teeth. Hormonal changes
associated with pregnancy are rarely seen in children. However, childhood pregnancy
results in greater degree of hypertrophy of gingiva with high bleeding tendency, needing
the use of electrocautery instead of blade dissection to avoid excessive bleeding.
Conclusion: This case is unique in that hormonal changes secondary to pregnancy was
thought to be the cause.

Virtual presentation at the MAPD 2021 Virtual Scientific Conference & AGM on 8March 2021

Dr Alia Aqilah Mohd Suhaimi
Dr Ganasalingam A/L Sockalingam
Department of Paediatric Dentistry
Hospital Tunku Azizah
Kuala Lumpur

74