Advertisement

Hemorrhoids and Anal Fissures During and After Pregnancy

Summary and Comment |
June 10, 2014

Hemorrhoids and Anal Fissures During and After Pregnancy

  1. Diane J. Angelini, EdD, CNM, FACNM, FAAN, NEA-BC

Risk factors for perianal symptoms included constipation during pregnancy and prolonged straining during labor.

  1. Diane J. Angelini, EdD, CNM, FACNM, FAAN, NEA-BC

Perianal symptoms, including hemorrhoids, anal fissures, discharge, bleeding, and pain, are common among women who have recently given birth. In a prospective observational cohort study to assess incidence of and risk factors for perianal disease in pregnancy, investigators in Lithuania examined 280 pregnant women (44% pregnant for the first time, 56% repeated pregnancies) at a university hospital and outpatient clinics during the first and third trimesters, immediately after delivery, and 1 month postpartum.

In all, 44% of participants developed perianal symptoms; of these women, 93% had hemorrhoids and 6% had hemorrhoids and anal fissures. More than half of the women with hemorrhoids had thrombosed hemorrhoids. The mean weight of newborns was 3545 g. Mean duration of straining or bearing down in labor was 13.4 minutes (range, 3–50 minutes), 20% of women had histories of perianal disease, and most perianal symptoms (61%) developed during the third trimester. Independent risk factors for perianal symptoms included constipation during pregnancy, personal history of perianal disease, newborn birth weight >3800 g, and straining duration >20 minutes during labor.

Comment

The majority of perianal symptoms emerged during the third trimester, and constipation was the only significant preventable risk factor; thus, prophylactic interventions for constipation (e.g., encouraging exercise and consumption of fiber and fluids) are best begun well before the third trimester. Given that prolonged straining or bearing down also was a significant risk factor, improved methods of avoiding difficult labor (e.g., encouraging passive fetal descent) could also help reduce the incidence of pregnancy-associated perianal symptoms.

  • Disclosures for Diane J. Angelini, EdD, CNM, FACNM, FAAN, NEA-BC at time of publication Editorial boards Journal of Perinatal and Neonatal Nursing

Citation(s):

Your Comment

(will not be published)

Filtered HTML

  • Allowed HTML tags: <a> <em> <strong> <cite> <blockquote> <code> <ul> <ol> <li> <dl> <dt> <dd>
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Do you have any conflict of interest to disclose?
CAPTCHA
This question is for testing whether you are a human visitor and to prevent automated spam submissions.
Image CAPTCHA
Enter the characters shown in the image.

Vertical Tabs

* Required

Reader comments are intended to encourage lively discussion of clinical topics with your peers in the medical community. We ask that you keep your remarks to a reasonable length, and we reserve the right to withhold publication of remarks that do not meet this standard.

PRIVACY: We will not use your email address, submitted for a comment, for any other purpose nor sell, rent, or share your e-mail address with any third parties. Please see our Privacy Policy.

Advertisement
Advertisement
Advertisement