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Bowel obstruction in pregnancy

M M Connolly1, J A Unti, P F Nora

  • 1Department of Surgery, Columbus Hospital, Chicago, Illinois.

The Surgical Clinics of North America
|February 1, 1995
PubMed
Summary

Intestinal obstruction in pregnancy is rare but serious, with maternal mortality decreasing significantly over time. However, fetal mortality remains high, emphasizing the need for prompt diagnosis and surgical intervention for both mother and fetus.

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Area of Science:

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

Background:

  • Intestinal obstruction during pregnancy and the puerperium is an uncommon but serious complication.
  • While maternal mortality has decreased significantly over the decades, fetal mortality remains high.
  • Previous abdominal or pelvic surgery increases the risk for pregnant patients.

Purpose of the Study:

  • To review the incidence, outcomes, and management of intestinal obstruction in pregnant patients.
  • To highlight the persistent high fetal mortality rates associated with this condition.
  • To emphasize the importance of early diagnosis and aggressive surgical intervention.

Main Methods:

  • Literature review of cases of intestinal obstruction in pregnancy and the puerperium.
  • Analysis of historical and modern maternal and fetal mortality rates.
  • Discussion of diagnostic challenges and treatment strategies.

Main Results:

  • Maternal mortality has decreased from over 60% in 1900 to approximately 6% in recent decades.
  • Fetal mortality rates have remained persistently high, between 20% and 26%.
  • Only one-third of patients with prenatal bowel obstruction complete term pregnancies after surgery.

Conclusions:

  • Intestinal obstruction in pregnancy poses a significant risk to both mother and fetus.
  • Timely diagnosis and aggressive surgical management are crucial to reduce morbidity and mortality.
  • Diagnostic and treatment protocols for pregnant patients should mirror those for non-pregnant individuals.

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