HEMORRHOIDAL DISEASE IN PREGNANT WOMEN AND IN THE POSTPARTUM PERIOD: BASICS OF DIAGNOSIS, CLINICAL PICTURE, TACTICS OF TREATMENT AND PREVENTION

Nobody is not insured from the most common proctological diseases. It is generally accepted that about 50 % of the population of developed countries complains of hemorrhoidal disease. This is especially true during pregnancy and the postpartum period. Hemorrhoids are one of the most common proctological problems in women during these periods. There is evidence in foreign literature that about 25–35 % of pregnant women suffer from symptomatic hemorrhoidal disease in one form or another. Russian authors provide data that clinically significant hemorrhoids occur in 50–65 % of postpartum women. The main treatment for symptomatic hemorrhoids in a pregnant woman is conservative therapy, and surgical treatment is performed only in exceptional cases when there is severe thrombosis of hemorrhoids with significant pain or massive and recurrent bleeding. Surgery carries various risks. This includes an increase in the incidence of postoperative bleeding, an increase in probability of premature birth and the development of persistent non-healing wound with pain, which reduces woman’s quality of life [8]. Issues of pharmacotherapy for hemorrhoids in pregnant and lactating women come down to issues of assessing the safety of drugs, primarily for the child. The risk of adverse effects may depend up the period of gestation. It is traditionally considered that prescription of medications is relatively safety from the second trimester of pregnancy, when the blood-placental barrier is formed. The article discusses cause factors of development of hemorrhoids during pregnancy, its classification, features of the clinical course of the disease, as well as issues of diagnosis and treatment tactics. The principles of disease prevention during pregnancy and the postpartum period are given.

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