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ACS Brief

Early Operation Reduces Risk of Mother and Fetus in Adhesive Small Bowel Obstruction during Pregnancy

February 25, 2025

Ashbrook MJ, Cheng V, Longo E, et al. Management of Adhesive Small Bowel Obstruction during Pregnancy in the United States. J Trauma Acute Care Surg. 2025; in press.

 

The authors used data from the National Inpatient Sample database to determine outcomes in pregnant patients diagnosed with adhesive small bowel obstruction over the interval 2003–2015.

Patients (n = 4,266) were divided into three groups: nonoperative management, operation within the first 24 hours after admission, and operation after the first hospital day.

Nonoperative management was successful in 46.3% of patients. The proportion of patients treated nonoperatively increased steadily during the study interval. Early operation occurred in 27.6% of patients, and delayed operation was performed in 21.6%.

The data analysis showed that nonoperative management and early operation were associated with similar rates of preterm labor and/or delivery, abortion, and maternal septic shock (2%–10%). Delayed operation was associated with a significant increase in risk of these complications.

The authors concluded that prompt diagnosis and early operation, when indicated, was associated with lower risk of harm to the mother and fetus. They recommended early surgical consultation to help achieve these goals.

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