Correct answer:

Internal haemorrhoids, or piles, are abnormal anal cushions, usually congested as a result of straining at stool, and traumatized by the passage of a hard stool. The anal cushions are particularly prominent in pregnancy owing to the venous congestion caused by the large gravid uterus and the laxity of the supporting tissues caused by the influence of progesterone. With the patient in the lithotomy position the usual arrangement is that three major piles occur at 3, 7 and 11 o’clock.