{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T10:56:12Z","timestamp":1793530572239,"version":"4.5.0"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,2,18]],"date-time":"2022-02-18T00:00:00Z","timestamp":1645142400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>Hemorrhoids and anal fissures occur in about 40% of pregnant women and women during postpartum period. Usually they occur during the third trimester of pregnancy and 1\u20132 days after giving birth. Constipation during pregnancy, perianal diseases during previous pregnancy and childbirth, instrumental delivery, straining duration of more than 20 min, and weight of the newborn more than 3,800 g are associated with hemorrhoids. Perianal diseases reduce the quality of life of both pregnant and postpartum women. In the absence of acute conditions, surgical treatment of hemorrhoids is delayed after pregnancy, childbirth, and lactation. Thrombosed internal hemorrhoids and perianal thrombosis are to be treated conservatively in most instances by prescribing adequate pain relief, oral, and topical flavonoid preparations.<\/jats:p>","DOI":"10.3389\/fsurg.2022.788823","type":"journal-article","created":{"date-parts":[[2022,2,18]],"date-time":"2022-02-18T00:31:40Z","timestamp":1645144300000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":28,"title":["Perianal Diseases in Pregnancy and After Childbirth: Frequency, Risk Factors, Impact on Women's Quality of Life and Treatment Methods"],"prefix":"10.3389","volume":"9","author":[{"given":"Diana","family":"Bu\u017einskien\u0117","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u017divil\u0117","family":"Sabonyt\u0117-Bal\u0161aitien\u0117","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Po\u0161kus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,2,18]]},"reference":[{"key":"B1","volume-title":"Ne\u0161\u010diuju ir gimdyviu i\u0161anges ligu da\u017dnis, rizikos veiksniai ir itaka moters gyvenimo kokybei: Daktaro disertacija","author":"Bu\u017einskien\u0117","year":"2015"},{"key":"B2","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1002\/bjs.1800620710","article-title":"The nature of haemorrhoids","volume":"62","author":"Thomson","year":"1975","journal-title":"Br J Surg."},{"key":"B3","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1016\/S0889-8553(02)00069-9","article-title":"Constipation, diarrhea, and symptomatic hemorrhoids during pregnancy","volume":"32","author":"Wald","year":"2003","journal-title":"Gastroenterol Clin North Am."},{"key":"B4","doi-asserted-by":"publisher","first-page":"231","DOI":"10.3109\/01443610903439242","article-title":"Haemorrhoids during pregnancy","volume":"30","author":"Avsar","year":"2010","journal-title":"J Obstet Gynaecol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1053\/j.tgie.2004.01.004","article-title":"Hemorrhoids: diagnosis and management","author":"Kann","year":"2004","journal-title":"Tech Gastrointest Endosc."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/j.1365-2036.2010.04278.x","article-title":"The diagnosis and management of haemorrhoidal disease from a global perspective","volume":"31","author":"A Abramowitz","year":"2010","journal-title":"Aliment Pharmacol Ther."},{"key":"B7","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1136\/bmj.327.7419.847","article-title":"Managing haemorrhoids","volume":"327","author":"Nisar","year":"2003","journal-title":"BMJ."},{"key":"B8","volume-title":"Hemorojaus Gydymo Metodu Palyginamasis Tyrimas: Daktaro Disertacija","author":"Po\u0161kus","year":"2008"},{"key":"B9","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1002\/bjs.5378","article-title":"Meta-analysis of flavonoids for the treatment of haemorrhoids","volume":"93","author":"Alonso-Coello","year":"2006","journal-title":"Br J Surg."},{"key":"B10","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1016\/j.bpg.2009.04.010","article-title":"Haemorrhoids, rectal prolapse, anal fissure, peri-anal fistulae and sexually transmitted diseases","volume":"23","author":"Felt-Bersma","year":"2009","journal-title":"Best Pract Res Clin Gastroenterol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.suc.2009.10.005","article-title":"Diagnosis and management of symptomatic hemorrhoids","volume":"90","author":"Sneider","year":"2010","journal-title":"Surg Clin North Am."},{"key":"B12","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1007\/s00384-009-0845-5","article-title":"Anorectal symptoms during pregnancy: how important is trimester?","volume":"25","author":"Unadkat","year":"2010","journal-title":"Int J Colorectal Dis."},{"key":"B13","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1016\/j.jamcollsurg.2006.08.022","article-title":"Hemorrhoidal disease: a comprehensive review","volume":"204","author":"Kaidar-Person","year":"2007","journal-title":"J Am Coll Surg."},{"key":"B14","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1016\/j.bpg.2007.06.001","article-title":"Impact of pregnancy and parturition on the anal sphincters and pelvic floor","volume":"21","author":"Quigley","year":"2007","journal-title":"Best Pract Res Clin Gastroenterol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1016\/S1701-2163(16)34246-3","article-title":"The effectiveness of Proctofoam-HC for treatment of hemorrhoids in late pregnancy","volume":"31","author":"Vohra","year":"2009","journal-title":"J Obstetr Gynaecol Can."},{"key":"B16","article-title":"NIH Publication No. 07\u20133021","year":"2004"},{"key":"B17","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/j.amjsurg.2006.04.021","article-title":"Surgical gastrointestinal disorders during pregnancy","volume":"193","author":"Parangi","year":"2007","journal-title":"Am J Surg."},{"key":"B18","doi-asserted-by":"publisher","first-page":"CD004077","DOI":"10.1002\/14651858.CD004077.pub2","article-title":"Conservative management of symptomatic and\/or complicated haemorrhoids in pregnancy and the puerperium","volume":"2005","author":"Quijano","year":"2005","journal-title":"Cochrane Database Syst Rev."},{"key":"B19","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1111\/j.1471-6712.2012.01044.x","article-title":"Women's perception of postpartum pelvic floor dysfunction and their help-seeking behaviour: a qualitative interview study","volume":"27","author":"Buurman","year":"2013","journal-title":"Scand J Caring Sci."},{"key":"B20","doi-asserted-by":"publisher","first-page":"2009","DOI":"10.3748\/wjg.v18.i17.2009","article-title":"Hemorrhoids: from basic pathophysiology to clinical management","volume":"18","author":"Lohsiriwat","year":"2012","journal-title":"World J Gastroenterol."},{"key":"B21","first-page":"1411","article-title":"Constipation, haemorrhoids, and heartburn in pregnancy","volume":"2010","author":"Vazquez","year":"2010","journal-title":"BMJ Clin Evidence."},{"key":"B22","first-page":"e99","article-title":"Anorectal symptom management in pregnancy: development of a severity scale","volume":"18","author":"Ebrahimi","year":"2011","journal-title":"J Populat Therap Clin Pharmacol."},{"key":"B23","first-page":"189","article-title":"Hemorrhoids in pregnancy","volume":"54","author":"Staroselsky","year":"2008","journal-title":"Can Family Phys."},{"key":"B24","doi-asserted-by":"publisher","first-page":"e48","DOI":"10.1111\/j.1463-1318.2010.02480.x","article-title":"Haemorrhoids and quality of life","volume":"13","author":"Riss","year":"2011","journal-title":"Colorectal Dis."},{"key":"B25","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/S0020-7292(97)02889-0","article-title":"Micronized flavonoid therapy in internal hemorrhoids of pregnancy","volume":"57","author":"Buckshee","year":"1997","journal-title":"Int J Gynecol Obstetr."},{"key":"B26","doi-asserted-by":"publisher","first-page":"CD004649","DOI":"10.1002\/14651858.CD004649.pub2","article-title":"Laxatives for the treatment of hemorrhoids","volume":"2005","author":"Alonso-Coello","year":"2005","journal-title":"Cochrane Database Syst Rev."},{"key":"B27","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1111\/j.1572-0241.2005.00359.x","article-title":"Fiber for the treatment of hemorrhoids complications: a systematic review and meta-analysis","volume":"101","author":"Alonso-Coello","year":"2006","journal-title":"Am J Gastroenterol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1460","DOI":"10.1111\/j.1471-0528.2000.tb11669.x","article-title":"The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of delivery","volume":"107","author":"MacLennan","year":"2000","journal-title":"Br J Obstet Gynaecol."},{"key":"B29","first-page":"183","article-title":"The significance of detailed examination of hemorrhoids during pregnancy","volume":"32","author":"Gojnic","year":"2005","journal-title":"Clin Exp Obstetr Gynecol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1007\/BF02090166","article-title":"Hemorrhoidectomy during pregnancy: risk or relief?","volume":"34","author":"Saleeby RG","year":"1991","journal-title":"Dis Colon Rectum."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1270","DOI":"10.1016\/S0399-8320(05)82220-1","article-title":"Risk factors associated with hemorrhoidal symptoms in specialized consultation","volume":"29","author":"Pigot","year":"2005","journal-title":"Gastroent\u00e9rol Clin Biol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"21509","DOI":"10.1038\/s41598-020-78625-3","article-title":"Comparison of pelvic floor dysfunction 6 years after uncomplicated vaginal versus elective cesarean deliveries: a cross-sectional study","volume":"10","author":"Baud","year":"2020","journal-title":"Sci Rep."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1641","DOI":"10.12669\/pjms.37.6-WIT.4859","article-title":"The effect of vaginal delivery and caesarean section on the anal sphincter complex of primipara based on optimized three-dimensional ultrasound image and nuclear regression reconstruction algorithm","volume":"37","author":"He","year":"2021","journal-title":"Pakistan J Med Sci."},{"key":"B34","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1186\/s12884-021-03817-2","article-title":"Influence of the second stage of labor on maternal and neonatal outcomes in vaginal births after caesarean section: a multicenter study in Germany","volume":"21","author":"Gitas","year":"2021","journal-title":"BMC Pregnancy Childbirth."},{"key":"B35","doi-asserted-by":"publisher","first-page":"1193","DOI":"10.1111\/j.1471-0528.1991.tb15386.x","article-title":"Health after childbirth","volume":"98","author":"MacArthur","year":"1991","journal-title":"Br J Obstet Gynaecol."},{"key":"B36","first-page":"3","article-title":"An alternative treatment for advanced hemorrhoidal disease","author":"Parker","year":"2005","journal-title":"OBG Manag."},{"key":"B37","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1007\/s10350-004-6262-5","article-title":"Anal fissure and thrombosed external hemorrhoids before and after delivery","volume":"45","author":"Abramowitz","year":"2002","journal-title":"Dis Colon Rectum."},{"key":"B38","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1080\/01443610400023064","article-title":"Predictors of women's physical health problems after childbirth","volume":"26","author":"Ansara","year":"2005","journal-title":"J Psychosomat Obstetr Gynecol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1016\/j.suc.2007.12.003","article-title":"Surgical diseases presenting in pregnancy","volume":"88","author":"Dietrich CS","year":"2008","journal-title":"Surg Clin North Am."},{"key":"B40","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/1475-2891-11-80","article-title":"Is a multispecies probiotic mixture effective in constipation during pregnancy?","volume":"11","author":"de Milliano","year":"2012","journal-title":"Nutr J"},{"key":"B41","article-title":"Constipation","author":"Basson","year":"2011","journal-title":"Medscape Reference."},{"key":"B42","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1007\/s00384-011-1316-3","article-title":"The prevalence of hemorrhoids in adults","volume":"27","author":"Riss","year":"2012","journal-title":"Int J Colorectal Dis."},{"key":"B43","doi-asserted-by":"publisher","first-page":"e227","DOI":"10.1111\/j.1463-1318.2011.02632.x","article-title":"Haemorrhoids, constipation and faecal incontinence: is there any relationship?","volume":"13","author":"Riss","year":"2011","journal-title":"Colorectal Dise."},{"key":"B44","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1111\/j.1523-536X.2008.00238.x","article-title":"Postpartum physical symptoms in new mothers: their relationship to functional limitations and emotional well-being","volume":"35","author":"Webb","year":"2008","journal-title":"Birth."},{"key":"B45","doi-asserted-by":"publisher","first-page":"1252","DOI":"10.1111\/jog.13640","article-title":"Effectiveness of antenatal perineal massage in reducing perineal trauma and post-partum morbidities: a randomized controlled trial","volume":"44","author":"Ugwu","year":"2018","journal-title":"J Obstetr Gynaecol Res."},{"key":"B46","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.ejogrb.2018.01.036","article-title":"Scientific evidence on perineal trauma during labor: Integrative review","volume":"223","author":"Vieira","year":"2018","journal-title":"Eur J Obstetr Gynecol Reproduct Biol."},{"key":"B47","doi-asserted-by":"publisher","first-page":"35","DOI":"10.31128\/AFP-09-17-4333","article-title":"Perineal tears - a review","volume":"47","author":"Goh","year":"2018","journal-title":"Aust J Gen Pract."},{"key":"B48","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1111\/birt.12258","article-title":"The effect of perineal lacerations on pelvic floor function and anatomy at 6 months postpartum in a prospective cohort of nulliparous women","volume":"43","author":"Leeman","year":"2016","journal-title":"Birth."},{"key":"B49","doi-asserted-by":"publisher","first-page":"168","DOI":"10.17772\/gp\/2058","article-title":"The role of episiotomy in prevention of genital lacerations during vaginal deliveries\u2013results from two European centers","volume":"86","author":"Lagan\u00e0","year":"2015","journal-title":"Ginekol Pol."},{"key":"B50","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1007\/s00404-019-05404-5","article-title":"Selective use of episiotomy: what is the impact on perineal trauma? Results from a retrospective cohort study","volume":"301","author":"Franchi","year":"2020","journal-title":"Arch Gynecol Obstet."},{"key":"B51","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1186\/s12884-021-04260-z","article-title":"Which elements were significant in reducing obstetric anal sphincter injury? A prospective follow-up study","volume":"21","author":"Rasmussen","year":"2021","journal-title":"BMC Pregnancy Childbirth."},{"key":"B52","doi-asserted-by":"publisher","first-page":"1989","DOI":"10.1007\/s00192-021-04786-y","article-title":"The OASI care bundle quality improvement project: lessons learned and future direction","volume":"32","author":"Jurczuk","year":"2021","journal-title":"Int Urogynecol J."},{"key":"B53","doi-asserted-by":"publisher","first-page":"1666","DOI":"10.1111\/1471-0528.12838","article-title":"Haemorrhoids and anal fissures during pregnancy and after childbirth: a prospective cohort study","volume":"121","author":"Poskus","year":"2014","journal-title":"BJOG."},{"key":"B54","doi-asserted-by":"publisher","first-page":"E666","DOI":"10.3390\/medicina55100666","article-title":"Factors influencing quality of life during the first trimester of pregnancy: a prospective cohort study","volume":"55","author":"Jakubauskiene","year":"2019","journal-title":"Medicina (Kaunas)."},{"key":"B55","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1097\/DCR.0000000000001642","article-title":"Evaluation and management of hemorrhoids","volume":"63","author":"Jakubauskas","year":"2020","journal-title":"Dis Colon Rectum."},{"key":"B56","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1007\/s00384-019-03460-6","article-title":"Results of the double-blind randomized controlled trial comparing laser hemorrhoidoplasty with sutured mucopexy and excisional hemorrhoidectomy","volume":"35","author":"Poskus","year":"2020","journal-title":"Int J Colorectal Dis."},{"key":"B57","doi-asserted-by":"publisher","first-page":"730261","DOI":"10.3389\/fsurg.2021.730261","article-title":"Local perianal anesthetic infiltration is safe and effective for anorectal surgery","volume":"8","author":"Poskus","year":"2021","journal-title":"Front Surg."}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2022.788823\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,18]],"date-time":"2022-02-18T00:31:50Z","timestamp":1645144310000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2022.788823\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,18]]},"references-count":57,"alternative-id":["10.3389\/fsurg.2022.788823"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2022.788823","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,18]]},"article-number":"788823"}}