TRIMESTER-WISE EVALUATION OF HEMORRHOIDS AND ANAL FISSURES DURING PREGNANCY AND POSTPARTUM: A PROSPECTIVE OBSERVATIONAL STUDY OF WOMEN
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Keywords
Pregnancy, postpartum, hemorrhoids, anal fissure, perianal disorders.
Abstract
Introduction: Pregnant women frequently experience haemorrhoids and anal fissures (HAF), which can significantly impair their quality of life. Despite the condition's prevalence, little is known about its natural course during pregnancy, there is little proof, and there are no official standards or recommendations for therapy.
Aim and Objective: To evaluate the prevalence and risk factors of hemorrhoids and anal fissures during pregnancy and postpartum.
Material and Methods: This was a Prospective observational study carried out in the Department of Obstetrics and Gynecology and Department of Surgery. The Women were assessed in four clinical visits. Those developing perianal diseases were compared with those who did not.
Results: In the present study a total of 300 women were studied out of which there were 147 (49%) who developed perianal disease. Most cases occurred in the third trimester (n=98; 66.6%), followed by the second trimester (n=33; 22.4%) and postpartum period (n=16; 10.9%). Among affected women, 106 (72.1%) had only hemorrhoids, while 41 (27.9%) had both hemorrhoids and anal fissure. Vaginal delivery occurred in 243 women (81%), and 57 (19%) underwent caesarean section. Significant risk factors included constipation (64%), prolonged straining during delivery (≥20 minutes), and baby weight >3900g.
Conclusion: Perianal diseases are common in late pregnancy and early postpartum, strongly associated with constipation, high birth weight, and prolonged second stage of labor.
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Dr. Shalini Raman
Assistant professor, Department of Obstetrics and Gynecology, Era Medical College, Lucknow, Uttar Pradesh, India
Dr. Bichitra Nath Shukla
Assistant professor, Department of General Surgery, Era Medical College, Lucknow, Uttar Pradesh, India.
Dr. Dinesh Kumar Singh
Assistant Professor, Department of Surgery, Rama Medical College Hospital and Research Centre, Uttar Pradesh, India.
Dr. Amalanshu Raman
Assistant professor, Department of General Surgery, Era Medical College, Lucknow, Uttar Pradesh, India.