Acute pseudo-obstruction of the colon (Ogilvie's syndrome) following instrumental vaginal delivery.
Acute pseudo-obstruction of the colon (Ogilvie's syndrome) is an adynamic ileus without mechanical obstruction of the bowel. Predisposing factors include: abdominal and pelvic surgery, or trauma, or severe pre-existing systemic illness. In obstetrics, many cases have been reported after caesarean delivery, but none following a vaginal delivery. Conservative and pharmacological therapies are effective in many patients, but surgical intervention may be required. Early diagnosis and appropriate treatment is imperative to avoid caecal rupture, faecal peritonitis and the associated high maternal mortality. High index of clinical suspicion and proper assessment of the gastrointestinal system in the post-surgical patient are vital to the management of this uncommon but potentially serious condition met with in obstetrics practice.
Kakarla
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Department of Obstetrics and Gynaecology, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, UK.
Posnett
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Jain
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Ash
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D000328:Adult; D002429:Cecal Diseases / Q000209:etiology; D003112:Colonic Pseudo-Obstruction / Q000209:etiology*; D005113:Extraction, Obstetrical / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology; D007744:Obstetric Labor Complications / Q000628:therapy*; D009772:Obstetrical Forceps / Q000009:adverse effects*; D011247:Pregnancy; D011644:Puerperal Disorders / Q000209:etiology*