Treatment of haemorrhoids in pregnant women and in perilabour period

Almost 25% of women suffers from haemorrhoids and the risk of the disease increases for women in reproductive age. Pregnant women are especially susceptible for hae­morrhoids. It is thought that as much as 85% of women who are between six and nine months pregnant suffer from haemorrhoids. It is connected with some physiological and anatomical changes characteristic for pregnancy and perilabour period. Hemodynamic factor is the most important one for the development of haemorrhoids in pregnant women and in perilabour period. Enlarged uterus creates a mechanical obstacle for free blood flow from haemorrhoids, and it can also increase the problem of constipation, which is one of the major causes of haemorrhoids. Increased levels of estrogens and progesterone in pregnant women results in decreasing tension of veins, increasing the volume of circulating blood, which directly burden the venous system. The increase of coagulability observed in pregnant women may cause thrombosis of haemmorhoids. Treatment of haemorrhoids in pregnant women should be conservative, except when bleeding haemorrhoids are the cause of anaemia which poses danger for both mother and child, and acute thrombosis which cannot be treated pharmacologically. The article describes ways of treatment of haemorrhoids in pregnant women and perilabour period. It presents dietary recommendations as well as medicines, including commonly applied flavonoids. Although there is no information about side effects of using flavonoids in either mother or child, the medicines should not be applied in women in first trimester of pregnancy, and in the last trimester they should be applied with great care and only if the patient is in great pain. The article also discusses reasons for the application of alternative methods of instrumental treatment as well as surgery.