What should be done if a pregnant woman experiences severe hemorrhoidal bleeding?

Pregnant women are a high-risk group for hemorrhoids, and nearly all expectant mothers develop hemorrhoids during pregnancy. Hemorrhoids typically appear in the third trimester, as the growing fetus causes the uterus to expand, thereby compressing pelvic veins and impairing venous return.

What should be done if a pregnant woman experiences severe hemorrhoidal bleeding?

In pregnant women, severe hemorrhoidal bleeding is most commonly attributable to internal hemorrhoids. During pregnancy, constipation and hard stools are frequent due to hormonal changes and reduced gastrointestinal motility, leading to straining during defecation. This may cause ulceration or rupture of the hemorrhoidal mucosa, resulting in significant bleeding. Management strategies include the following:

• Apply topical hemorrhoid ointment directly to the bleeding area, or insert a hemorrhoid suppository into the rectum. These preparations generally possess anti-inflammatory, hemostatic, and analgesic properties.

• If symptoms persist, apply povidone-iodine to a Vaseline-impregnated gauze pad and gently insert it into the anus to apply direct pressure to the bleeding site for hemostasis.

• If conservative measures fail, surgical intervention may be considered—such as rubber band ligation or hemorrhoidectomy. Any intraoperative or postoperative medications must be carefully selected to minimize potential risks to the fetus.

Alternatively, massage therapy may be beneficial. Two target areas are recommended: the perianal region and the abdomen. After bowel movements, apply a warm, damp towel to the anal area and massage gently in both clockwise and counterclockwise directions for 15 minutes each. For abdominal massage, lie supine and use both hands to massage the lower abdomen—15 strokes clockwise and 15 strokes counterclockwise—twice daily (morning and evening). This promotes intestinal motility, facilitates regular bowel movements, prevents constipation, and supports hemorrhoid resolution. Such massage helps accelerate intestinal transit and thus plays a preventive role against constipation—a key contributing factor in hemorrhoid development.

We hope the above information is helpful. Wishing you a healthy and joyful pregnancy!