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Anal disorders in pregnant and postpartum women: epidemiological, diagnostic and therapeutic aspects in 10 maternities of Bamako in Mali.
- Source :
-
The Pan African medical journal [Pan Afr Med J] 2024 Feb 14; Vol. 47, pp. 66. Date of Electronic Publication: 2024 Feb 14 (Print Publication: 2024). - Publication Year :
- 2024
-
Abstract
- Bowel transit disturbances favored by pregnancy and injuries during childbirth would be triggering or aggravating factors for anal pathologies. The objective of this work was to study the epidemiology, diagnosis, and treatment of anal pathologies during pregnancy and 6 weeks after delivery. We carried out a prospective, multi-centric, and analytical study in 10 obstetric units in Bamako from June 1 <superscript>st</superscript> , 2019, to May 31 <superscript>st</superscript> , 2020. After informed consent, we enrolled all first-trimester pregnant women admitted to the hospitals and who were followed up through the postpartum. We conducted a rectal examination in each participant and an anoscope in those with an anal symptom. Hemorrhoidal diseases were diagnosed in the case of external hemorrhoids (thrombosis or prolapse) or internal hemorrhoids. During the study period, we followed up 1,422 pregnant women and we found 38.4% (546) with anal pathologies (hemorrhoidal diseases in 13% (192), anal fissure in 10.5% (150) and anal incontinence in 8.6% (123). Risk factors for the hemorrhoidal disease were age of patient ≥30 years old aRR=5.77, 95% CI 4.57-7.34; p=0.000; a existence of chronic constipation aRR=2.61, 95% CI 1.98-3.44; p=0.000; newborn weight >3500 g aRR= 1.61, 95% CI 1.25-2.07; p=0.000 and fetal expulsion time >20 minutes aRR= 6.04, 95% CI 5.07-7.27; p=0.000. The clinical signs observed were constipation, anal pain, bleeding, and pruritus. The treatment was based on counseling on hygiene and diet, the use of laxatives, local topicals, and analgesics along perineal rehabilitation. Anal pathologies were common during pregnancy and 6 weeks after delivery. Pregnant women must be screened systematically for such pathologies. Early diagnostic and appropriate treatment would reduce serious complications.<br />Competing Interests: The authors declare no competing interests.<br /> (Copyright: Adégné Togo et al.)
- Subjects :
- Humans
Female
Pregnancy
Mali epidemiology
Adult
Prospective Studies
Young Adult
Risk Factors
Fissure in Ano diagnosis
Fissure in Ano therapy
Fissure in Ano epidemiology
Fecal Incontinence epidemiology
Fecal Incontinence etiology
Fecal Incontinence diagnosis
Constipation epidemiology
Constipation diagnosis
Follow-Up Studies
Adolescent
Hemorrhoids epidemiology
Hemorrhoids diagnosis
Hemorrhoids therapy
Pregnancy Complications epidemiology
Pregnancy Complications diagnosis
Pregnancy Complications therapy
Anus Diseases epidemiology
Anus Diseases diagnosis
Anus Diseases therapy
Postpartum Period
Subjects
Details
- Language :
- English
- ISSN :
- 1937-8688
- Volume :
- 47
- Database :
- MEDLINE
- Journal :
- The Pan African medical journal
- Publication Type :
- Academic Journal
- Accession number :
- 38681103
- Full Text :
- https://doi.org/10.11604/pamj.2024.47.66.36210