PROSPECTIVE EVALUATION OF HEMORRHOIDS AND ANAL FISSURES ACROSS PREGNANCY TRIMESTERS AND THE POSTPARTUM PERIOD

Abstract

Introduction: Hemorrhoids and anal fissures are among the most common perianal disorders affecting pregnant women, particularly during the later stages of gestation and the early postpartum period. These conditions can significantly affect maternal comfort and quality of life. Despite their prevalence, limited data exist regarding their trimester-wise incidence and associated risk factors in Indian populations.

Aim and Objective: To assess the prevalence, trimester-wise distribution, and risk factors associated with hemorrhoids and anal fissures during pregnancy and postpartum among women attending a tertiary care centre.

Material and Methods: This prospective observational study included 250 pregnant women evaluated across four stages—first trimester, third trimester, immediate postpartum, and one month postpartum. Women presenting with perianal symptoms were clinically examined and compared to asymptomatic participants. Data were analyzed using multivariate regression.

Results: Among 250 women, 118 (47.2 %) developed perianal disorders. The majority occurred in the third trimester (n = 80; 67.8 %), followed by the second trimester (n = 25; 21.2 %) and postpartum period (n = 13; 11 %). Hemorrhoids alone were present in 84 (71.2 %) cases, while 34 (28.8 %) had both hemorrhoids and fissures. Constipation (62 %), fetal weight > 3900 g, and straining during delivery were key risk factors. Vaginal delivery was observed in 202 (80.8 %) women, and cesarean section in 48 (19.2 %).

Conclusion: Perianal diseases are highly prevalent during late pregnancy and early postpartum, largely driven by constipation, prolonged second stage of labor, and higher birth weights. Early preventive counseling and conservative interventions can reduce maternal morbidity.