The clinical manifestation of plaque-induced gingival inflammation is modulated by the hormonal imbalances during pregnancy. Different forms of severity have been described. During the first months of the pregnancy, the persistent influence of the plaque induces catarrhal inflammation of the gingiva that serves as a base for the development of hyperplastic gingivitis during the last months, modulated by the cumulating hormonal stimuli. In non-controlled cases a development of pyogenic granuloma can be observed. This lesion is rarely observed in women with poor oral hygiene in regions with local irritating factors such as improperly fit obturation or dental calculus and needs specialized treatment. During pregnancy the pyogenic granuloma when treated surgically by excision may reappear due to incomplete excision or non-adequate oral hygiene. The clinical cases presented demonstrate the necessity of prophylaxis and constant control of gingival inflammation during pregnancy and the need of specialized treatment in severe cases.