Document Detail

Anal fissure and thrombosed external hemorrhoids before and after delivery.
MedLine Citation:
PMID:  12004215     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Thrombosed external hemorrhoids and anal fissures are common and are responsible for severe discomfort during childbirth. However, the real incidence of these lesions is unknown. The aim of our study was to evaluate their incidence and the risk factors for these lesions during childbirth. METHODS: A prospective study with proctologic examination during the last 3 months of pregnancy and after delivery (within 2 months) was performed in 165 consecutive pregnant females. RESULTS: Fifteen females (9.1 percent) with anal lesions (13 thrombosed external hemorrhoids and 2 anal fissures) were observed during pregnancy. Fifty-eight females (35.2 percent) with anal lesions (33 thrombosed external hemorrhoids and 25 anal fissures) were observed during the postpartum period. Ninety-one percent of thrombosed external hemorrhoids were observed during the first day after delivery, whereas anal fissures were distributed, with no peak, over the two months after delivery. The 2 independent risk factors for anal lesions (among obstetric, baby's, and mother's information) were dyschezia, with a 5.7 odds ratio (95 percent confidence interval, 2.7-12), and late delivery, with a 1.4 odds ratio (95 percent confidence interval, 1.05-1.9). Furthermore, many thrombosed external hemorrhoids were observed after superficial perineal tears and heavier babies (P < 0.05). Only 1 of the 33 patients with thrombosed external hemorrhoids who were observed underwent a cesarean section. CONCLUSION: One third of females have thrombosed external hemorrhoids or anal fissures in the postpartum period. The most important risk factor is dyschezia. Traumatic delivery appears to be associated with thrombosed external hemorrhoids.
Laurent Abramowitz; Iradj Sobhani; Jean Louis Benifla; Albert Vuagnat; Emile Daraï; Michel Mignon; Patrick Madelenat
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  45     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-10     Completed Date:  2002-07-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  650-5     Citation Subset:  IM    
FAMA de Coloproctologie, Service de Gastroentérologie et de Gynécologie-Obstétrique, Hôpital Bichat-Claude Bernard, Paris, France.
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MeSH Terms
Anal Canal / blood supply,  injuries*
Chi-Square Distribution
Constipation / complications*
Fissure in Ano / epidemiology,  etiology*
Hemorrhoids / epidemiology,  etiology*
Logistic Models
Prospective Studies
Puerperal Disorders / epidemiology,  etiology*
Risk Factors
Statistics, Nonparametric
Thrombosis / epidemiology,  etiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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