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Anorectal symptoms in pregnancy and the postpartum period
Amy L O'Boyle1, John D O'Boyle, Everett F Magann
1Department of Obstetrics, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA.
Objective:
To determine the frequency of anorectal complaints in nulliparous, pregnant women before and after delivery.
Study Design:
This was a prospective, observational study. Nulliparous, pregnant women attending an active-duty prenatal clinic completed a 6-item anorectal symptom questionnaire that assessed anal continence and defecatory symptoms.
Results:
Seventy-five active-duty, nulliparous women completed 158 questionnaires. Anorectal symptoms were reported both antepartum (AP) and postpartum (PP): straining to defecate (AP: 28-59%; PP: 30%), hard or lumpy stools (AP: 48-59%; PP: 66%), incomplete emptying (AP: 38-53%; PP: 38%), uncontrolled loss of gas or stool from the rectum (AP: 18-29%; PP: 15%), unpreventable soilage of underwear (AP: 15-33%; PP: 13%) and splinting (AP: 3-9%; PP: 9%). Constipation symptoms were reported most frequently in the first trimester (p = 0.031) and anal incontinence most often in the third trimester but loss of gas or stool "often" more in the postpartum period (p = 0.027). Anal incontinence was more frequent in women who delivered by forceps (p = 0.007).
Conclusion:
Anorectal symptoms are common both during pregnancy and in the postpartum period. Anal incontinence is reported more frequently in women who delivered by forceps.
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