TRIMESTER-BASED ASSESSMENT OF HEMORRHOIDS AND ANAL FISSURES DURING PREGNANCY AND POSTPARTUM: A PROSPECTIVE STUDY AMONG WOMEN"
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Keywords
Pregnancy, postpartum, hemorrhoids, anal fissures, constipation, perianal disorders, multicentric study
Abstract
: Hemorrhoids and anal fissures are among the most frequent anorectal disorders affecting pregnant and postpartum women. Physiological, hormonal, and mechanical changes during gestation increase susceptibility to perianal pathology.
Aim and Objective: This prospective study aimed to assess prevalence, trimester-wise distribution, and associated risk factors for hemorrhoids and anal fissures among pregnant women across tertiary care centres in North India.
Material and Methods: A total of 510 pregnant women were enrolled from three tertiary care centres between April 2024 and September 2025. Each participant underwent clinical evaluation at four intervals—first trimester, third trimester, immediate postpartum, and one month postpartum. Women with gastrointestinal, inflammatory bowel, or malignancy-related conditions were excluded. Data were analyzed using SPSS v26 with logistic regression.
Results: Out of 510 women, 252 (49.4%) developed perianal disorders. The majority occurred in the third trimester (n = 173; 68.6%), followed by the second trimester (n = 54; 21.4%) and postpartum period (n = 25; 9.9%). Hemorrhoids alone were present in 180 (71.4%) cases, while 72 (28.6%) had both hemorrhoids and fissures. Constipation (64.2%), prolonged second stage of labour, and birth weight >3900 g were key risk factors (p < 0.05). Vaginal delivery was observed in 414 (81.2%) and cesarean section in 96 (18.8%).
Conclusion: Perianal disorders remain a common maternal morbidity during late pregnancy and postpartum, predominantly driven by constipation, high fetal weight, and prolonged labour. Early antenatal screening and preventive measures are critical for reducing incidence and improving quality of life.
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Dr. Tanusha Ruth Das
Assistant Professor, Department of Obstetrics and Gynaecology, Prasad Institute of Medical Sciences, Uttar Pradesh, India.
Dr. Vijayshree Verma
Assistant Professor, Department of Community Medicine, MRAMC, Ambedkar Nagar, Uttar Pradesh, India.
Dr. Sheela Sharma
Professor, Department of Obstetrics and Gynaecology, Rama Medical College Hospital and Research Centre, Uttar Pradesh, India
Dr. Nashra Afaq
Assistant Professor, Department of Microbiology and Central Research Laboratory, Rama Medical College Hospital and Research Centre, Uttar Pradesh, India.
Dr. Nazia Nesar
Associate Professor, Department of Obstetrics and Gynaecology, Integral Institute of Medical Sciences, Uttar Pradesh, India.
Dr. Akshat Agarwal
Assistant Professor, Department of Surgery, Rohilkhand Medical College, Bareilly, Uttar Pradesh, India.
Dr. Anubha Varshney
Assistant Professor, Department of Obstetrics and Gynaecology, Rama Medical College Hospital and Research Centre, Uttar Pradesh, India