Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent University, Gent, Belgium.
Department of Gynaecology and Obstetrics, Ghent University Hospital, Ghent University, Gent, Belgium.
Colorectal Dis. 2018 Dec;20(12):1109-1116. doi: 10.1111/codi.14324. Epub 2018 Aug 3.
The aim was to determine the prevalence and risk factors of anal symptoms prepartum and postpartum.
A prospective observational cohort study was carried out in Ghent University Hospital, Belgium. Ninety-four pregnant women between their 19th and 25th week of pregnancy were included. An anal symptom questionnaire was filled in at four different times: in the second and third trimester, immediately postpartum and 3 months postpartum. Descriptive data were obtained from patient files. A proctological diagnosis was presumed on the basis of combined symptoms (i.e. rectal bleeding, anal pain and swelling). Constipation was defined by the Rome III criteria. Risk factors were identified using multivariate analysis.
Sixty-eight per cent of the patients developed anal symptoms. The most prevalent symptom was anal pain. Constipation was reported by 60.7% during the study period. Seven women (7.9%) suffered from faecal incontinence. The most prevalent diagnoses were haemorrhoidal thrombosis (immediately postpartum), haemorrhoidal prolapse (in the third trimester and immediately postpartum) and anal fissure (not episode related). The two independent risk factors for anal complaints were constipation, with a 6.3 odds ratio (95% CI 2.08-19.37), and a history of anal problems, with a 3.9 odds ratio (95% CI 1.2-13). The Bristol Stool Chart was shown to be a reliable indicator in pregnancy and postpartum as significant correlations were observed in all study periods.
Two-thirds of pregnant women have anal symptoms during pregnancy and postpartum, especially haemorrhoidal complications and anal fissure. The most important risk factor is constipation. The prevention of constipation in pregnant women is therefore highly recommended.
旨在确定产前和产后肛门症状的流行率和危险因素。
在比利时根特大学医院进行了一项前瞻性观察性队列研究。纳入了 94 名妊娠 19-25 周的孕妇。在四个不同时间点填写肛门症状问卷：妊娠中期和晚期、产后即刻和产后 3 个月。从患者档案中获得描述性数据。根据联合症状（即直肠出血、肛门疼痛和肿胀）假定直肠疾病诊断。便秘根据罗马 III 标准定义。使用多变量分析确定危险因素。
68%的患者出现肛门症状。最常见的症状是肛门疼痛。研究期间有 60.7%的患者报告便秘。7 名女性（7.9%）患有粪便失禁。最常见的诊断是产后即刻的痔血栓形成、妊娠晚期和产后即刻的痔脱垂以及与发作无关的肛裂。肛门不适的两个独立危险因素是便秘，其优势比为 6.3（95%CI 2.08-19.37），以及肛门问题史，其优势比为 3.9（95%CI 1.2-13）。布里斯托粪便图表在妊娠和产后期间是一种可靠的指标，因为在所有研究期间都观察到了显著的相关性。
三分之二的孕妇在妊娠和产后期间有肛门症状，尤其是痔并发症和肛裂。最重要的危险因素是便秘。因此，强烈建议预防孕妇便秘。
