Sarcouncil Journal of Medicine and Surgery

Abstract: Hemorrhoids, also known as piles, are characterised by the swelling of the veins in the rectum. This condition is prevalent among individuals suffering from constipation. The prevalence of hemorrhoids during pregnancy is multifactorial, with potential causes including an enlarged uterus, which exerts pressure on the intestines, and exertion during labor. The present study aims to evaluate the outcomes of hemorrhoid surgery in women during the first trimester of pregnancy. The study enrolled 100 patients from Iraq over a one-year period from January 2024 to February 2025, with ages ranging from 18 to 40 years. The surgical procedures employed in this study were Stapled hemorrhoidopexy, laser hemorrhoidoplasty, and rubber band ligation. The study was a prospective cohort study conducted at a tertiary hospital in Iraq. The study enrolled pregnant women (gestational age ≤13 weeks) with symptomatic Grade III-IV hemorrhoids who were scheduled to undergo surgical intervention. Exclusion criteria encompassed high-risk pregnancies, coagulation disorders, and previous surgeries on the anorectum. The surgical procedures assessed were Milligan-Morgan hemorrhoidectomy, stapled hemorrhoidopexy (PPH), laser hemorrhoidoplasty, and rubber band ligation. A comprehensive set of perioperative characteristics was documented, encompassing pain scores (measured using the Visual Analog Scale), complications (including bleeding, infection, thrombosis, and miscarriage), recovery time, and pregnancy outcomes (term/preterm delivery). The statistical analyses employed included descriptive statistics, comparative tests, and regression models. The preliminary findings include Pain Relief, and a significant decrease in pain scores (VAS) was observed post-surgery, with minimally invasive methods such as laser/PPH demonstrating accelerated recovery and fewer complications. The bleeding rate was recorded at 5 percent, infections at 3 percent, and miscarriages at less than 2 percent. These findings indicate that, when appropriate patients are selected, the procedures are relatively safe. In terms of pregnancy outcomes, the majority of patients delivered at term, and there was no significant increase in labour before term or fetal distress. Patient satisfaction was high, with scores of 4-5 on the Likert scale for symptom relief. However, some patients required further interventions during pregnancy and after delivery