Hemorrhoids are the most common chronic disease of the anus, formed by the varicose and enlarged venous plexus in the lower part of the anal canal and rectum. Because of the special physiological factors and anatomical differences between women and men, hemorrhoids have more predisposing factors. Among the various physiological periods of women, pregnancy has the highest incidence of hemorrhoids, and Masahiro Takano found that 72% of all cases of hemorrhoids appear or worsen due to pregnancy and childbirth. The incidence of hemorrhoids can be more than 80% with three or more pregnancies. The causes of hemorrhoids in pregnant women a. Uterine compression 1. The increasingly distended uterus compresses the inferior vena cava, while a large amount of blood is injected from the uterine veins into the internal iliac vein to obstruct pelvic venous reflux, causing the pelvic venous pressure to rise up to 10 mmHg (1.3 kpa), resulting in obstructed blood flow back, plus a defective internal iliac vein valve, slowing down the blood flow in the anorectal plexus by almost half and increasing venous tortuous expansion. With the gradual increase of the uterine body, the pressure on the inferior vena cava becomes more and more aggravated, especially when the fetal position is not correct, the pressure is more obvious. 2.The enlarged uterus compresses the intestinal canal and causes defecation obstruction, the stool becomes hard and the force of defecation increases. 3.The enlarged uterus in late pregnancy causes damage to the pelvic floor support tissues by continuous stretching, as the uterus gradually expands with the growth of the fetus, the rectus abdominis and pelvic floor muscles are constantly stretched and relaxed, and even some muscle fibers are broken. The increased arterial blood flow required by the uterus leads to increased burden of microcirculation in the anal cushion and abnormal arterial anastomosis. Second, hormonal effects 1, pregnancy, most of the coagulation factors concentration and activity are increased, this change from the early pregnancy that began, to the end of the third month of pregnancy reached a peak. Coagulation factors I, II, V, VII, VIII, IX and X are increased, and fibrinogen can increase 2-3 times. The anticoagulant function is reduced during pregnancy, for example, AT-III activity is reduced. Therefore, the coagulation-anticoagulation system of the body’s internal environment is in a hypercoagulable state. Therefore, the blood is abnormally hypercoagulable and prone to thrombosis. 2, hemorrhoids local blood flow slowdown, can lead to the anal cushion arteriovenous anastomosis regulation disorder, stimulate sympathetic excitation, cause anastomotic tube spasm, tissue ischemia and hypoxia, followed by the anal cushion tissue due to hypoxic stimulation release of histamine, produce local histamine effect, capillary pre-capillary sphincter spasm, arteriovenous anastomosis tube suddenly open, resulting in the hemorrhoidal venous plexus blood flow aggregation increase, expansion of congestion, because at this time the capillaries closed. As the capillaries are closed, arterial blood flows directly into the veins through the arteriovenous anastomoses, thus aggravating the hypoxia of the anal cushion tissue, which in turn stimulates the secretion of local histamine and aggravates the dilation of the anastomoses, leading to stagnation of venous blood flow, tissue edema, and thrombosis, etc. 3, after pregnancy, the body produces a large amount of progesterone, due to the influence of progesterone, the gastrointestinal tract smooth muscle tone, peristalsis is reduced, weakened, so that the food in the gastrointestinal tract emptying delayed, prolonged transmission time in the intestine, resulting in excessive retention time in the intestine, water reduction, dry stool easy to constipation. Constipation when defecation, force to struggle, abdominal pressure further increase, resulting in hemorrhoid attacks, hemorrhoid area mucous membrane erosion and bleeding, or the original hemorrhoid nucleus prolapse outside the anus, or even embedded and cause edema, necrosis, resulting in severe anal pain and other symptoms. 4, progesterone relaxin and other pregnancy hormones, making vasodilatation, tissue relaxation; and make the pelvic floor and anal canal support tissue relaxation, aggravating the anal cushion downward migration. The influence of lifestyle habits 1, due to the influence of traditional concepts, most of the pregnancy diet is based on protein, and carbohydrate intake is insufficient, the role of intestinal flora on the fermentation of intestinal contents is reduced, so that the stool is easy to alkaline, dry, causing constipation, thus aggravating anal disease. 2. Insufficient activity during pregnancy, the enlarged uterus squeezes the lower end of the rectum and the anal canal, causing the nucleus of the hemorrhoid to prolapse and become embedded. The prevention and treatment of hemorrhoids in pregnant women a. Topical drugs Topical treatment allows the drug to act directly on the lesion, which can reduce and eliminate the main symptoms. For pregnant women who are not suitable for surgery, it is safe to use without toxic side effects. Yu Suping used Wu Bei Zi, Da Huang, Sheng Pu Huang, Kulan and Bing Qi to make hemorrhoid eliminating powder to treat late pregnancy embedded hemorrhoids, twice a day for 3 days. Zhang Jingyan treated 60 cases of post-pregnancy internal hemorrhoid bleeding with taining suppository, and the efficiency reached 100% in 2 weeks. Zhou Min treated pregnant mothers with hemorrhoids with a self-designed Chinese ointment (Scutellaria baicalensis, Phellodendron cinnabarum, Rhubarb, Diyu, Phellodendron spp. and Tian Qi powder powder were powdered and mixed with petroleum jelly to make a paste) with an efficiency of 96%; Wang Fu-chun used Phellodendron cinnabarum, Rhubarb, Job’s tears, Zeligia, Angelica sinensis and Yanhuo to grind into fine powder and mixed with white petroleum jelly to make an anti-swelling and pain-relieving paste to treat maternal ingrown hemorrhoids. The treatment time was 1-7 d, with an average of 3.6 d. All 70 patients had their hemorrhoids shrink, no longer prolapsed, and their pain disappeared. The emphasis should not only be on reducing swelling and pain, but also on relieving impaction. Although the symptoms can disappear quickly after topical medication, it cannot be cured. In order to avoid recurrence, we should pay attention to daily diet and life regulation, and keep the bowels open. Fumigation Fumigation can cause local vasodilatation of the anus through the synergistic effect of pharmacology and warmth, so that the active ingredients of the drug can play a therapeutic role through the mucous membrane of the skin, which can unblock and harmonize the local qi-blood meridians and promote local blood circulation and lymph circulation in the anus, thus improving the symptoms and promoting the improvement and recovery of local functions, and achieving the purpose of treating hemorrhoids. It is non-premature and non-toxic for pregnant women and can be applied to patients with hemorrhoids during pregnancy who do not undergo surgery and other more complex treatments. Chen Weihong treated inflammatory, thrombosed external hemorrhoids during pregnancy with a sitz bath using a self-prepared red, swollen and pain-relieving soup (Huang Bai, Licorice, Wild Chrysanthemum, Di Yu, Fang Feng, Wu Mei, Boswellia, Myrrh, Wu Bei Zi, Park Nian, and Ice Tablets). The treatment course was 2-3 times a day for 7 d. 30 cases were cured by one course of treatment, with a cure rate of 72.3%. The treatment of maternal hemorrhoids with a fumigation bath of Pao Xinmin (Radix Paeoniae, Salviae Miltiorrhizae, Astragali, Angelicae Sinensis, Radix et Rhizoma Ginseng, Cortex Phellodendron, Radix et Rhizoma Lactuca, and Radix Phellodendron). The treatment was twice daily for 7 d. The effect was remarkable. Wang Liying treated 518 cases of maternal hemorrhoids with a sitz bath using self-prepared soup (Huang Lian, Huang Qin, Jin Yin Hua, Ban Lan Gen, Fishy Herb, Bai Bai, Huang Bai, Da Huang, Huang Ginseng, Serpentine, Sichuan pepper, Bai Zhi, Bai Xian Pi, Angelicae, Di Shen Zi, Fang Feng, and Slippery Rock). The effect was 97.2%. The perianal skin and mucous membrane edema of patients in the acute stage of hemorrhoids is due to sphincter spasm rather than inflammation, which does not affect surgery. Zhou Jingguo et al. treated one case of embedded mixed hemorrhoids in a pregnant woman with external stripping and internal ligation under lumbar acupoint anesthesia. Magnesium sulfate was administered intravenously before and after surgery to prevent abortion due to contractions; penicillin was administered intravenously for anti-inflammation; hemostatic min was administered intravenously after surgery to stop bleeding; and fumigation was performed with a self-prepared traditional Chinese medicine formula. Thirteen days after surgery, the hemorrhoid nucleus was completely detached. Both Chen Hui and Li Yong used PPH to treat 18 and 46 cases of pregnancy hemorrhoids. None of them had recurrence one year after surgery, and they would not affect pregnancy. This shows that surgical treatment of mixed hemorrhoids in pregnant women is safe and feasible, with complete hemorrhoid treatment, less recurrence, no anal incontinence or stenosis, and no induced miscarriage or preterm delivery, and no effect on postoperative transvaginal delivery. However, not all pregnant women are suitable for surgical treatment. According to Zheng Huaimei, for pregnant women who are not suitable for surgical treatment, especially before 28 weeks of gestation, mental and physical burdens such as violent mood swings, trauma, and stimulation of surgical operations can lead to preterm labor Functional exercises Functional exercises are easy to perform, and can be done anytime and anywhere, and they are not restricted by time, place, or environment, and are suitable for pregnant women who do not want to undergo surgery or use medication. It can prevent pelvic vein stasis, enhance blood circulation, and also make the whole pelvic muscles get exercise, which has obvious prevention and treatment effects on maternal hemorrhoids and other diseases, and it is safe and effective. Wu Bin et al. divided 90 pregnant women into a control group with conventional intervention and an intervention group with conventional intervention plus anal health exercises and recorded them at 14, 24 and 36 weeks of pregnancy for comparison. The incidence of hemorrhoids was found to be 19.5% in the intervention group, which was lower than that of 30.2% in the control group. There were no adverse events or adverse reactions in either group. The anal health care exercises were as follows: The first section of the exercise is to exhale the old and to keep the Shen Que. Action: After rubbing the two palms together to generate heat, gently place them on the navel, close the eyes and concentrate on the Shen Que, breathe in deeply and then breathe out. The second section combs the Baihui point. Movements: both elbows up, fingers do combing action, from front to back, stroking the acupuncture points, alternating between the two hands. The third section of the ear massage. Movements: both thumbs are placed on the back of the ear, the index finger is bent and placed inside the auricle, rubbing the whole ear from top to bottom. The fourth section rubs and presses the Erbai point. Action: press and knead the right arm point with the left thumb, then rub the point with the radial side of the left thumb from 10 cm above and below the point, from the inner arm to the palm of the hand. The fifth section shakes the knee. Movements: relax the body, both hands hold the small of the abdomen does not move, smooth breathing, the left leg is fixed, the right leg lifted in a circle, while the right foot from the inside and outside the circular circle. Both legs alternate. The sixth section shrinks the valley road. Movements: both hands hold the small of the abdomen, legs clenched, tongue against the palate, inhalation of the anus hard internal suction lifting, a slight pause and then relax and exhale. Each group of 10 times, 2-3 groups each time. Pregnant women, as a group with a high incidence of hemorrhoids, should first pay attention to the cultivation of dietary habits from life, including drinking more water, changing the structure of the diet, more dietary fiber, good bowel habits, heart conditioning, etc. These measures are the first step in the prevention and treatment of hemorrhoids.