Does Pregnancy Weight Gain Have an Effect on the Frequency of Postpartum Anorectal Disease?

Öz

Background: Thrombosed external hemorrhoids (TEH) and anal fissure are benign anorectal diseases that seriously impair the quality of life during pregnancy and the postpartum period. The actual incidence of these lesions in the population and the relationship between their progression and pregnancy are not well known. The aim of our study is to determine the incidence of TEH and anal fissure that develop from the last trimester of pregnancy to the first postpartum month and to reveal the relationship be-tween this condition and the weight gained during pregnancy, newborn weight and the duration of the second phase of labor. Materials and Methods: Among the pregnant patients who applied to the gynecology and general sur-gery outpatient clinic between July 25, 2021 and October 25, 2021, patients who had TEH and anal fissure in the third trimester and the first postpartum month and whose records were complete were followed prospectively and analyzed retrospectively. Weight gain of patients in the third trimester was calculated as a percentage. All third trimester pregnant patients were examined at least three times by an obstetrician or general surgeon while they were asymptomatic and in the first postpartum month. Patients with a previous history of surgery due to hemorrhoidal disease were not included in the study. Results: In patients developing TEH; Weight gain during pregnancy, baby birth weight, and prolongation of the second phase of labor were determined as risk factors (p=0.003, p<0.001, p<0.001, p<0.001, respectively). Among the risk factors for anal fissure, weight gain during pregnancy, baby birth weight, and prolongation of the second phase of labor were determined (p=0.003, p<0.001, p<0.001, p<0.001, respectively). It was observed that the first birth being a normal spontaneous vaginal birth and being overweight before pregnancy did not cause an increase in the frequency of TEH and anal fissure. Conclusions: Weight gain during pregnancy, baby birth weight and prolongation of the second phase of labor can be considered as risk factors for the development of Anorectal diseases such as TEH and anal fissure. Key Words: Anal fissure, Hemorrhoids, Pregnancy

Postpartum Anorektal Hastalık Sıklığında Gebelikte Alınan Kilo Etkili midir?

Öz

GİRİŞ: Tromboze eksternal hemoroid (TEH) ve anal fissür gebelik sırasında ve postpartum dönemde hayat kalitesini ciddi şekilde bozan benign anorektal hastalıklardandır. Bu lezyonların toplumdaki gerçek insidansı ve gebelikle progrese olması arasındaki ilişki yeterince bilinmemektedir. Çalışmamızın amacı gebeliğin son trimesterı ile postpartum birinci aya kadar gelişen TEH ve anal fissür insidansını saptamak ve bu durumun gebelik boyunca alınan kilo, yenidoğan ağırlığı ve doğumun ikinci fazındaki süre ile olan ilişkisini ortaya koyabilmektir. MATERIAL VE METHOD: 25 Temmuz 2021- 25 Ekim 2021 tarihleri arasında kadın doğum ve genel cerrahi polikliniğine başvuran gebe hastalar içinden üçüncü trimester ve postpartum birinci ayda TEH ve anal fissür görülen, kayıtları tam olan hastalar prospektif takip edilip retrospektif analiz edildi. Üçüncü trimesterda olan hastaların kilo artışı yüzde olarak hesaplandı. Tüm üçüncü trimester hamile hastalar asemptomatik iken ve postpartum ilk ayda, kadın doğum uzmanı veya genel cerrah tarafından en az üç kez muayene edildiler. Daha önceden hemoroidal hastalık nedeniyle operasyon öyküsü olan hastalar çalışmaya dahil edilmedi. BULGULAR: TEH gelişen hastalarda; gebelik sırasında kilo artışı, bebek doğum ağırlığı, doğumun ikinci fazının uzaması risk faktörleri olarak saptandı (sırası ile p=0,003 p<0,001 p<0,001 p<0,001). Anal fissür risk faktörleri arasında ise gebelikte kilo artışı, bebek doğum ağırlığı, doğumun ikinci fazının uzaması saptandı (sırası ile p=0,003 p<0,001 p<0,001 p<0,001). İlk doğumun normal spontan vajinal doğum olması ve gebelik öncesi kilo fazlalığının TEH ve anal fissür sıklığında bir artışa neden olmadığı gözlemlendi. Sonuç: Gebelikte kilo alımı, bebek doğum ağırlığı ve doğumun ikinci fazının uzaması TEH ve anal fissür gibi Anorektal hastalıkların gelişimi açısından risk faktörü olarak sayılabilir.

Anahtar Kelimeler

• Anal fissure
• Hemorrhoid
• Pregnancy. Anorectal diseases

Kaynakça

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