title: 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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  Anorectal symptoms are common both during pregnancy and in the postpartum period. Anal incontinence is reported more frequently in women who delivered by forceps.
authors.affiliation: Department of Obstetrics, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA.
authors.forename: Amy L
authors.initials: AL
authors.lastname: O'Boyle
authors.forename: John D
authors.initials: JD
authors.lastname: O'Boyle
authors.forename: Everett F
authors.initials: EF
authors.lastname: Magann
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Rieg
authors.forename: John C
authors.initials: JC
authors.lastname: Morrison
authors.forename: Gary D
authors.initials: GD
authors.lastname: Davis
mesh_terms: D000293:Adolescent; D000328:Adult; D003248:Constipation / Q000453:epidemiology* / Q000473:pathology; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000379:methods; D005242:Fecal Incontinence / Q000453:epidemiology*; D005260:Female; D005414:Flatulence / Q000209:etiology; D006801:Humans; D017773:Pelvic Floor / Q000503:physiopathology; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000473:pathology; D011264:Pregnancy Trimesters; D011446:Prospective Studies; D012007:Rectum / Q000503:physiopathology; D011795:Surveys and Questionnaires