| Abstract [eng] |
Considerable hormonal, anatomical changes as well as altered blood circulation in the small pelvis during pregnancy have a direct impact on the rectum and peri-anal area. Pregnancy and childbirth are predisposing factors of peri-anal diseases. External hemorrhoids thrombosis and fissures are the two most common causes of peri-anal pathology during pregnancy and after childbirth. These diseases not only disrupt a normal process of pregnancy, delivery or the period after childbirth, but also can be a cause of the woman’s poor quality of life in the future. In Lithuania, even though the issue of peri-anal pathology in pregnant women has been highlighted by the popular press, so far there is not a single scientific medical study conducted on the subject, nor there are any available data on the incidence of peri-anal pathology in Lithuania. Our study attempts to be the first prospective cohort study of peri-anal diseases in pregnancy and after childbirth that involves monitoring of women throughout pregnancy and over the first month after delivery, determining the incidence and risk factors of these diseases as well as their impact on the woman’s quality of life. The study aimed to evaluate peri-anal diseases during pregnancy and after childbirth, their incidence and association with the woman’s physical condition and health, peculiarities characteristic to pregnancy and childbirth, the indicators of a newborn’s physical condition, as well as risk factors for peri-anal diseases and their impact on the woman’s quality of life. All the pregnant women were investigated at Obstetrics and Gynecology Clinic of Vilnius University in 2010-2011. The examination focused on pregnant women of 18-45 years of age who contacted their family doctor or an obstetrician gynecologist for pregnancy care provision at the Central branch of Out-Patient Clinic of PI Santariskiu Clinics and Antakalnis Out-Patient Clinic of Vilnius City, as well as women after delivery and treatment undergone at Obstetrics and Gynecology Unit of the Central Branch of PI Santariskiu Clinics. Research methods: survey questionnaire, colorectal surgeon examination (digital rectal examination, anoscopy), anthropometric investigation (the height of pregnant women, the body weight, women’s body mass index), statistical analysis of the data. We found that the most common peri-anal diseases in pregnancy and after childbirth are hemorrhoids and peri-anal fissure with frequency of 43.9% and the most common time of occurrence being the third trimester of pregnancy and the first or the second day after delivery. Risk factors for peri-anal diseases in pregnancy, during delivery and after childbirth: constipation during pregnancy, peri-anal diseases during previous pregnancy and childbirth, instrumental mode of delivery (vacuum extraction of the fetus and forceps), straining duration (> 20 min); indicators of a newborn’s physical condition (> 3800 g newborn’s birth weight). Peri-anal diseases worsen the quality of life of both, pregnant and postpartum women. |
