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Small bowel obstruction in pregnancy

S Meyerson1, T Holtz, M Ehrinpreis

  • 1Veterans Administration Hospital, Wilmington, Delaware.

The American Journal of Gastroenterology
|February 1, 1995
PubMed
Summary
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Small bowel obstruction (SBO) is a rare but serious pregnancy complication. Early clinical suspicion and prompt imaging are crucial for managing SBO in pregnant patients.

Area of Science:

  • Obstetrics and Gynecology
  • Surgical Gastroenterology
  • Maternal-Fetal Medicine

Background:

  • Small bowel obstruction (SBO) is an uncommon complication during pregnancy.
  • Pregnancy-associated SBO can lead to significant maternal and fetal morbidity.

Purpose of the Study:

  • To review the experience with small bowel obstruction (SBO) in pregnant patients at two urban hospitals.
  • To identify key clinical features, diagnostic challenges, and outcomes of SBO during pregnancy.

Main Methods:

  • Retrospective chart review of pregnant patients diagnosed with intestinal obstruction.
  • Data collected from January 1972 to January 1992 at two Detroit urban hospitals.
  • Analysis of patient demographics, clinical presentation, diagnostic methods, and treatment outcomes.

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Main Results:

  • Nine cases of SBO were identified in 150,386 deliveries (1:16,709).
  • Most cases occurred in the second or third trimester; eight patients had prior abdominal surgery.
  • Symptoms included abdominal pain, vomiting, and obstipation; diagnosis was challenging, with incorrect initial diagnoses in four patients.
  • Eight surgical interventions were performed, with one requiring bowel resection; three fetal deaths occurred, but no maternal deaths.

Conclusions:

  • Small bowel obstruction is a rare but potentially catastrophic complication of pregnancy and the puerperium.
  • High clinical suspicion is essential, particularly in patients with a history of abdominal surgery.
  • Prompt diagnostic workup including imaging and surgical consultation is warranted upon suspicion of SBO.