CORRELATION BETWEEN VARIOUS ANTHROPOMETRIC AND MUSCULOSKELETAL MEASUREMENTS AND HEMORRHOIDS IN PREGNANCY
Abstract
Purpose: The aim of this study was to determine the presence of hemorrhoids in pregnancy and symptoms related to hemorrhoids and to evaluate the relationship between hemorrhoids in pregnancy and various anthropometric and musculoskeletal parameters.
Methods: The retrospective cross-sectional study included pregnant women in 3 different trimesters (1st, 11-15 weeks; 2nd, 16-23 weeks; 3rd, 24-40 weeks) without any anorectal problems before pregnancy. The presence of hemorrhoids and other anorectal symptoms during pregnancy was evaluated with yes/no questions on self-reported scales.
Results: Evaluation was made of 268 pregnant women (92, 1st Trimester; 107, 2nd Trimester; 69, 3rd trimester). In the whole study sample, waist circumference measurement (p = 0.042; OR = 1.13; 95% CI 1.07–1.92), bi-iliac width (p = 0.036; OR = 1.17; 95% CI 1.09–1.38), rectus abdominis muscle strength (p = 0.006; OR = 0.45; 95% CI 0.04–0.58), Diastasis-recti-abdominis grade measured from umbilicus level (p = 0.023; OR = 1.38; 95% CI 1.14–1.83), hypermobility score (p = 0.006; OR = 3.34; 95% CI 1.98–7.94) and parity (p = 0.032; OR = 2.47; 95% CI 1.85–7.19) were found to be important risk factors for the presence of hemorrhoids in pregnancy.
Conclusion: This is the first study to have evaluated hemorrhoids and hemorrhoid-related symptoms and to examine the associated risk factors comprehensively. It was also demonstrated for the first time that waist circumference measurement, bi-iliac width, increased grade of Diastasis-recti-abdominis measured at umbilicus level, hypermobility score, and decreased rectus abdominis muscle strength were risk factors for hemorrhoids in pregnancy.
References
- Avsar A, Keskin H. Haemorrhoids during pregnancy. J Obstet Gynaecol. 2010;30(3):231-7.
- Gojnic M, Dugalic V, Papic M, Vidaković S, Milićević S, Pervulov M. The significance of detailed examination of hemorrhoids during pregnancy. Clin. Exp. Obstet. Gynecol. 2005;32(3):183-4.
- Medich DS, Fazio VW. Hemorrhoids, anal fissure, and carcinoma of the colon, rectum, and anus during pregnancy. Surg Clin North Am. 1995;75(1):77-88.
- Abramowitz L, Sobhani I, Benifla JL, Vuagnat A, Daraï E, Mignon M, et al. Anal fissure and thrombosed external hemorrhoids before and after delivery. Dis Colon Rectum. 2002;45(5):650-5.
- Lee J-H, Kim H-E, Kang J-H, Shin J-Y, Song Y-M. Factors associated with hemorrhoids in korean adults: korean national health and nutrition examination survey. Korean J Fam Med. 2014;35(5):227.
- Plackett TP, Kwon E, Gagliano RA, Oh RC. Ehlers-Danlos Syndrome—Hypermobility Type and Hemorrhoids. Case Rep Surg. 2014;2014.
- Lohsiriwat V. Hemorrhoids: from basic pathophysiology to clinical management. World J Gastroenterol. 2012;18(17):2009.
- Lewis S, Heaton K. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol. 1997;32(9):920-4.
- Barber M, Walters M, Bump R. Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol. 2005;193(1):103-13.
- Celenay ST, Akbayrak T, Kaya S, Ekici G, Beksac S. Validity and reliability of the Turkish version of the Pelvic Floor Distress Inventory-20. Int Urogynecol J. 2012;23(8):1123-7.
- Organization WH. Waist circumference and waist-hip ratio: report of a WHO expert consultation, Geneva, 8-11 December 2008. 2011.
- Heinz G, Peterson LJ, Johnson RW, Kerk CJ. Exploring relationships in body dimensions. J Stat Educ. 2003;11(2).
- Cuthbert SC, Goodheart GJ. On the reliability and validity of manual muscle testing: a literature review. Chiropr Osteopat. 2007;15(1):4.
- Sadeghi R, Mosallanezhad Z, Nodehi-Moghadam A, Nourbakhsh MR, Biglarian A, Ezati K. The Reliability of Bubble Inclinometer and Tape Measure in Determining Lumbar Spine Range of Motion in Healthy Individuals and Patients.USWR. . 2015;5(3):137- 44
- Salamh PA, Kolber M. The reliability, minimal detectable change and concurrent validity of a gravity-based bubble inclinometer and iphone application for measuring standing lumbar lordosis. Physiother Theory Pract. 2014;30(1):62-7. Mota P, Pascoal AG, Sancho F, Carita AI, Bø K. Reliability of the inter-rectus distance measured by palpation. Comparison of palpation and ultrasound measurements. Man. Ther.. 2013;18(4):294-8.
- Castori M, Morlino S, Dordoni C, Celletti C, Camerota F, Ritelli M, et al. Gynecologic and obstetric implications of the joint hypermobility syndrome (aka Ehlers–Danlos syndrome hypermobility type) in 82 Italian patients. Am. J. Med. Genet. Part A. 2012;158(9):2176-82.
- Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J. Clin. Epidemiol.. 1996;49(12):1373-9.
- Cottrell BH, Shannahan MD (1986) Effect of the birth chair on duration of second stage labor and maternal outcome. Nursing research 35 (6):364-367
- Corby H, Donnelly V, O’herlihy C, O’connell P (1997) Anal canal pressures are low in women with postpartum anal fissure. British journal of surgery 84 (1):86-88
- Shirah BH, Shirah HA, Fallata AH, Alobidy SN, Al Hawsawi MM (2018) Hemorrhoids during pregnancy: Sitz bath vs. ano-rectal cream: A comparative prospective study of two conservative treatment protocols. Women and Birth 31 (4):e272-e277
- Poskus T, Buzinskienė D, Drasutiene G, Samalavicius N, Barkus A, Barisauskiene A, Tutkuviene J, Sakalauskaite I, Drasutis J, Jasulaitis A (2014) Haemorrhoids and anal fissures during pregnancy and after childbirth: a prospective cohort study. BJOG: An International Journal of Obstetrics & Gynaecology 121 (13):1666- 1671
- Brusciano L, Limongelli P, del Genio G, Rossetti G, Sansone S, Healey A, et al. Clinical and instrumental parameters in patients with constipation and incontinence: their potential implications in the functional aspects of these disorders. Int. J. Colorectal Dis.. 2009;24(8):961-7.
- Kera T, Maruyama H (2005) The effect of posture on respiratory activity of the abdominal muscles. Journal of physiological anthropology and applied human science 24 (4):259-265
- Handa VL, Pannu HK, Siddique S, Gutman R, VanRooyen J, Cundiff G (2003) Architectural differences in the bony pelvis of women with and without pelvic floor disorders. Obstetrics & Gynecology 102 (6):1283-1290
- Sze EH, Kohli N, Miklos JR, Roat T, Karram MM (1999) Computed tomography comparison of bony pelvis dimensions between women with and without genital prolapse. Obstetrics & Gynecology 93 (2):229-232
- Noble E, Mittelmark RA, Keith LG (1988) Essential exercises for the childbearing year: a guide to health and comfort before and after your baby is born. Houghton Mifflin
- Akbayrak T, AkarcalI İ, ÇItak İ, Kara F. Gebelikte Diastasis Recti Abdominis, Rectus Abdominus Kas Kuvveti ve Bel Ağrısı Arasındaki İlişki. Am J Obstet Gynecol.. 2001;11(4):215-9.
- Konkler C (1990) Principles of exercise for the obstetric patient,[w:] C. Kisner, LA Colby LA (red) Therapeutic exercise foundations and techniques, ed 2:547-576
- Ireland ML, Ott SM (2000) The effects of pregnancy on the musculoskeletal system. Clinical Orthopaedics and Related Research (1976-2007) 372:169-179
- Willis S, Junge K, Ebrahimi R, Prescher A, Schumpelick V. Haemorrhoids–a collagen disease? Int. J. Colorectal Dis.. 2010;12(12):1249-53.
- Riss S, Weiser FA, Schwameis K, Riss T, Mittlböck M, Steiner G, Stift A (2012) The prevalence of hemorrhoids in adults. International journal of colorectal disease 27 (2):215-220
- Peery AF, Sandler RS, Galanko JA, Bresalier RS, Figueiredo JC, Ahnen DJ, Barry EL, Baron JA (2015) Risk factors for hemorrhoids on screening colonoscopy. PLoS One 10 (9):e013910
GEBELİKTE GÖRÜLEN HEMOROİD İLE ANTROPOMETRİK ÖLÇÜMLER VE KAS-İSKELET SİSTEMİ ÖLÇÜMLERİ ARASINDAKİ İLİŞKİNİN İNCELENMESİ
Abstract
Amaç: Bu çalışmanın amacı, gebelikte hemoroid varlığı ve hemoroid ile ilgili semptomları incelemek ve gebelikte hemoroid varlığı ile çeşitli antropometrik ve muskuloskeletal parametreler arasındaki ilişkiyi araştırmaktı.
Metod: Bu retrospektif kesitsel çalışmaya gebelik öncesi herhangi bir anorektal problemi olmayan, 3 farklı trimesterdaki (1. Trimester, 11-15 hafta, 2. Trimester, 16-23 hafta, 3. Trimester, 24-40 hafta) gebeler dahil edildi. Gebelikte hemoroid ve diğer anorektal semptomların varlığı self-reported olarak var/yok şeklinde değerlendirildi.
Bulgular: Çalışmaya 268 gebe (92, 1. trimester; 107, 2. trimester; 69, 3. trimester). Tüm çalışma örnekleminde bel çevre ölçümü (p= 0,042; OR = 1,13; % 95 CI 1,07–1,92), bi-iliak genişlik (p= 0,036; OR = 1,17; % 95 CI 1,09–1,38), rectus abdominis kas kuvveti (p= 0,006; OR = 0,45; % 95 CI 0,04–0,58), umbilikus seviyesinden ölçülen diastazis rekti abdominis (DRA) miktarı (p= 0,023; OR = 1,38; % 95 CI 1,14–1,83), hipermobilite skoru (p= 0,006; OR = 3,34; % 95 CI 1.98–7,94) ve doğum sayısı (p= 0,032; OR = 2,47; % 95 CI 1,85–7,19) hemoroid gelişiminde önemli risk faktörleri olarak bulundu.
Sonuç: Bu çalışma, hemoroid ve hemoroid ile ilişkili semptomları değerlendiren ve hemoroid ile ilişkili risk faktörlerini uygun örneklem genişliği ile kapsamlı olarak değerlendiren tek çalışmadır. Aynı zamanda gebelikte, bel çevre ölçümünün, bi-iliak genişliğin, umblikus seviyesinden ölçülen DRA miktarının ve hipermobilite skorunun artmasının ve rektus abdominis kas kuvvetinin azalmasının hemoroid açısından risk faktörü olduğu ilk kez bu çalışma ile ortaya konulmuştur.
Keywords
References
- Avsar A, Keskin H. Haemorrhoids during pregnancy. J Obstet Gynaecol. 2010;30(3):231-7.
- Gojnic M, Dugalic V, Papic M, Vidaković S, Milićević S, Pervulov M. The significance of detailed examination of hemorrhoids during pregnancy. Clin. Exp. Obstet. Gynecol. 2005;32(3):183-4.
- Medich DS, Fazio VW. Hemorrhoids, anal fissure, and carcinoma of the colon, rectum, and anus during pregnancy. Surg Clin North Am. 1995;75(1):77-88.
- Abramowitz L, Sobhani I, Benifla JL, Vuagnat A, Daraï E, Mignon M, et al. Anal fissure and thrombosed external hemorrhoids before and after delivery. Dis Colon Rectum. 2002;45(5):650-5.
- Lee J-H, Kim H-E, Kang J-H, Shin J-Y, Song Y-M. Factors associated with hemorrhoids in korean adults: korean national health and nutrition examination survey. Korean J Fam Med. 2014;35(5):227.
- Plackett TP, Kwon E, Gagliano RA, Oh RC. Ehlers-Danlos Syndrome—Hypermobility Type and Hemorrhoids. Case Rep Surg. 2014;2014.
- Lohsiriwat V. Hemorrhoids: from basic pathophysiology to clinical management. World J Gastroenterol. 2012;18(17):2009.
- Lewis S, Heaton K. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol. 1997;32(9):920-4.
- Barber M, Walters M, Bump R. Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol. 2005;193(1):103-13.
- Celenay ST, Akbayrak T, Kaya S, Ekici G, Beksac S. Validity and reliability of the Turkish version of the Pelvic Floor Distress Inventory-20. Int Urogynecol J. 2012;23(8):1123-7.
- Organization WH. Waist circumference and waist-hip ratio: report of a WHO expert consultation, Geneva, 8-11 December 2008. 2011.
- Heinz G, Peterson LJ, Johnson RW, Kerk CJ. Exploring relationships in body dimensions. J Stat Educ. 2003;11(2).
- Cuthbert SC, Goodheart GJ. On the reliability and validity of manual muscle testing: a literature review. Chiropr Osteopat. 2007;15(1):4.
- Sadeghi R, Mosallanezhad Z, Nodehi-Moghadam A, Nourbakhsh MR, Biglarian A, Ezati K. The Reliability of Bubble Inclinometer and Tape Measure in Determining Lumbar Spine Range of Motion in Healthy Individuals and Patients.USWR. . 2015;5(3):137- 44
- Salamh PA, Kolber M. The reliability, minimal detectable change and concurrent validity of a gravity-based bubble inclinometer and iphone application for measuring standing lumbar lordosis. Physiother Theory Pract. 2014;30(1):62-7. Mota P, Pascoal AG, Sancho F, Carita AI, Bø K. Reliability of the inter-rectus distance measured by palpation. Comparison of palpation and ultrasound measurements. Man. Ther.. 2013;18(4):294-8.
- Castori M, Morlino S, Dordoni C, Celletti C, Camerota F, Ritelli M, et al. Gynecologic and obstetric implications of the joint hypermobility syndrome (aka Ehlers–Danlos syndrome hypermobility type) in 82 Italian patients. Am. J. Med. Genet. Part A. 2012;158(9):2176-82.
- Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J. Clin. Epidemiol.. 1996;49(12):1373-9.
- Cottrell BH, Shannahan MD (1986) Effect of the birth chair on duration of second stage labor and maternal outcome. Nursing research 35 (6):364-367
- Corby H, Donnelly V, O’herlihy C, O’connell P (1997) Anal canal pressures are low in women with postpartum anal fissure. British journal of surgery 84 (1):86-88
- Shirah BH, Shirah HA, Fallata AH, Alobidy SN, Al Hawsawi MM (2018) Hemorrhoids during pregnancy: Sitz bath vs. ano-rectal cream: A comparative prospective study of two conservative treatment protocols. Women and Birth 31 (4):e272-e277
- Poskus T, Buzinskienė D, Drasutiene G, Samalavicius N, Barkus A, Barisauskiene A, Tutkuviene J, Sakalauskaite I, Drasutis J, Jasulaitis A (2014) Haemorrhoids and anal fissures during pregnancy and after childbirth: a prospective cohort study. BJOG: An International Journal of Obstetrics & Gynaecology 121 (13):1666- 1671
- Brusciano L, Limongelli P, del Genio G, Rossetti G, Sansone S, Healey A, et al. Clinical and instrumental parameters in patients with constipation and incontinence: their potential implications in the functional aspects of these disorders. Int. J. Colorectal Dis.. 2009;24(8):961-7.
- Kera T, Maruyama H (2005) The effect of posture on respiratory activity of the abdominal muscles. Journal of physiological anthropology and applied human science 24 (4):259-265
- Handa VL, Pannu HK, Siddique S, Gutman R, VanRooyen J, Cundiff G (2003) Architectural differences in the bony pelvis of women with and without pelvic floor disorders. Obstetrics & Gynecology 102 (6):1283-1290
- Sze EH, Kohli N, Miklos JR, Roat T, Karram MM (1999) Computed tomography comparison of bony pelvis dimensions between women with and without genital prolapse. Obstetrics & Gynecology 93 (2):229-232
- Noble E, Mittelmark RA, Keith LG (1988) Essential exercises for the childbearing year: a guide to health and comfort before and after your baby is born. Houghton Mifflin
- Akbayrak T, AkarcalI İ, ÇItak İ, Kara F. Gebelikte Diastasis Recti Abdominis, Rectus Abdominus Kas Kuvveti ve Bel Ağrısı Arasındaki İlişki. Am J Obstet Gynecol.. 2001;11(4):215-9.
- Konkler C (1990) Principles of exercise for the obstetric patient,[w:] C. Kisner, LA Colby LA (red) Therapeutic exercise foundations and techniques, ed 2:547-576
- Ireland ML, Ott SM (2000) The effects of pregnancy on the musculoskeletal system. Clinical Orthopaedics and Related Research (1976-2007) 372:169-179
- Willis S, Junge K, Ebrahimi R, Prescher A, Schumpelick V. Haemorrhoids–a collagen disease? Int. J. Colorectal Dis.. 2010;12(12):1249-53.
- Riss S, Weiser FA, Schwameis K, Riss T, Mittlböck M, Steiner G, Stift A (2012) The prevalence of hemorrhoids in adults. International journal of colorectal disease 27 (2):215-220
- Peery AF, Sandler RS, Galanko JA, Bresalier RS, Figueiredo JC, Ahnen DJ, Barry EL, Baron JA (2015) Risk factors for hemorrhoids on screening colonoscopy. PLoS One 10 (9):e013910
Details
| Primary Language | English |
|---|---|
| Subjects | Rehabilitation |
| Journal Section | Araştırma Makaleleri |
| Authors | |
| Publication Date | April 20, 2024 |
| Published in Issue | Year 2024 Volume: 35 Issue: 1 |
