Nonobstetric Surgical Emergencies in Pregnancy

Oldenkamp, Caitlin L.; Kitamura, Kellie

doi:10.1016/j.emc.2023.01.001

Cited by 3 publications

(1 citation statement)

References 46 publications

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“…Obstetric conditions include ectopic pregnancy, septic abortion, placental abruption, chorioamnionitis, premature labor, and uterine rupture [ 1 ]. The common non-obstetric causes seen in pregnancy are appendicitis, cholecystitis, gastroenteritis, and pancreatitis [ 2 – 7 ]. Intestinal obstruction in pregnancy (IOP) is rare with reported incidence rates of 0.001–0.003% [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Intestinal obstruction in pregnancy—a rare presentation of uterine perforation

Shen

Teng

Chen

et al. 2023

BMC Pregnancy Childbirth

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Background Intestinal obstruction is an uncommon non-obstetric condition during pregnancy which may cause maternal and fetal mortality. Clinicians are confronted with challenges in diagnosis and treatment of intestinal obstruction due to the overlapping symptoms, concerns over radiological evaluation, and surgical risks. Case presentation We reported a 39-year old, gravida 7, para 2, woman who suffered from acute intestinal obstruction at 34 weeks of gestation. Ultrasonography and abdominal computed tomography were applied for intestinal obstruction diagnose. Conservative treatment was initially attempted. But following ultrasound found the absence of fluid in the amniotic sac and the patient showed no improvement in clinical symptoms. An emergency caesarean section was then performed. Intra-operative assessment showed dense adhesion between the left wall of uterus and omentum, descending colon, and sigmoid colon. After adhesion dialysis, uterine rupture with complete opening of the uterine wall at the site of left uterine cornua was found without active bleeding. The uterine rupture was then repaired. Conclusions Although uncommon during pregnancy, clinical suspicion of bowel obstruction is necessary especially in women with a history of abdominal surgery. Surgical intervention is indicated when conservative therapy fails and when there are signs of abnormal fetal conditions and worsened symptoms.

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