Anorectal symptoms in pregnancy and the postpartum period.

ABSTRACT

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.