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Old 10-12-2010
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ObGyn Quick Question about Hemorrhoids in Pregnancy

Had a quick question guys, whats the reason for hemorrhoids in pregnancy? and does that have any relation to the valsalva maneuver? I thought I read it somewhere regarding hemorrhoids, just can't remember for the life of me, where and what!

any help would be appreciated! thanks
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Old 10-12-2010
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From Wikipedia:

Quote:
During pregnancy, pressure from the fetus on the abdomen and hormonal changes cause the hemorrhoidal vessels to enlarge. Delivery also leads to increased intra-abdominal pressures.
Valsalva maneuvre increases both intrathoracic and intraabdominal pressures. Theoritically this can cause hemorrhoids, but it needs to be done for very prolonged periods of time (i.e. being chronic), which is rationally impossible!
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Old 10-12-2010
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Info Why constipation and hemorrhoids in pregnancy

During pregnancy there's increase progesterone levels which leads to relaxation of smooth muscles including those of the intestinal tract and this in turn causes increase in transit time and therefore more time for water absorption leading to hardened stools and constipation.

Constipation itself predisposes to hemorrhoids.

Another physiological reason is the enlarging uterus pressing on the colon further obstructing the move of colonic content and further obstruction the venous drainage thereby predisposing to constipation and hemorrhoids respectively.

The valsalva maneuver can be used to diagnosed internal hemorrhoids as they tend to prolapse during increased intraabdominal pressure but am not sure what relation this has got to do with pregnancy.
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Old 10-12-2010
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I think constipation is the major risk factor causing hemorrhoids in pregnancy.
In addition to the factors already discussed the gravid uterus also compresses the inf. vena cava causing inc pressure in the haemorrhoidal veins which also contibutes to the hemorrhoids formation.

Also these are mostly seen later in the pregnancy (3rd trimester) and usually no treatment is required after delivery.
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