Intestinal obstruction during pregnancy-a review and report of two cases

Geetha Lakshmi R and Saraswathi K

Intestinal obstruction in pregnancy is a rare entity. Herein we report two cases of sub-acute intestinal obstruction during pregnancy, one was conservatively managed, whereas the other was intervened for obstetric cause. Case1:Second gravida with 31 weeks and 4 days of pregnancy with previous histories of treated abdominal tuberculosis and laparoscopic bowel adhesiolysis, presented with pain abdomen, vomiting. Sonographic evidence consistent with intestinal obstruction. Patient was managed conservatively with parenteral supplements, nasogastric decompression and foetal monitoring. In course of management she delivered a preterm neonate spontaneously, followed by regression of her symptoms. Case2: Second gravida with 37 completed weeks complicated with central placenta praevia, presented with pain abdomen, nausea, vomiting and constipation for short duration with spotting per vaginum. Emergency Caesarean section proceeded, which ended up in caesarean hysterectomy and coincidental finding of peritoneal reflection compressing distal ileum, which was severed and an uneventful postoperative period. Hence, intestinal obstruction during pregnancy though uncommon, needs high index of suspicion for diagnosis, management and to prevent maternal, foetal morbidity and mortality.

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