Constipation in obstetrics - an underrated sign
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20253122Keywords:
HELLP syndrome, Obstetric near miss, DIC, Jaundice in pregnancy, Obstetric HDU nursingAbstract
An interesting case of normotensive hemolysis, elevated liver function tests, and low platelet counts (HELLP) syndrome with only presenting symptom of severe constipation near term; an occult sign of liver disease. She presented in active labour with mild jaundice and early signs of disseminated intravascular coagulation (DIC). This was an obstetric near miss, as it was a fine balancing act combined with aggressive monitoring and nursing management by highly skilled team of trained obstetric nurse midwives. This was a humbling lesson which reminded us not to ignore aggravated commonly occurring symptom in all patients of obstetrics. Availability of fresh whole blood makes it easier to manage such cases as fresh components are extremely difficult to procure and process in remote obstetric units.
Metrics
References
Snooks SJ, Barnes PR, Swash M, Henry MM. Damage to the innervation of the pelvic floor musculature in chronic constipation. Gastroenterology. 1985;89(5):977-81.
Garret C, Diarmuid O'D. Constipation and pregnancy, Best Pract Res Clin Gastroenterol. 2007;21(5):807-18. DOI: https://doi.org/10.1016/j.bpg.2007.05.005
Snooks SJ, Barnes PRH, Swash M, Henry MM. Damage to the innervation of the pelvic floor musculature in chronic constipation, Gastroenterol. 1985;89(5):977-81. DOI: https://doi.org/10.1016/0016-5085(85)90196-9
HELLP syndrome. Avaible at: https://bestpractice.bmj.com/topics/en-us/1000. Accessed on 12 June 2025.
Sibai BM, Ramadan MK, Usta I, Salama M, Mercer BM, Friedman SA. Maternal morbidity and mortality in 442 pregnancies with hemolysis, elevated liver enzymes and low platelets (HELLP syndrome). Am J Obstet Gynecol. 1993;169(4):1000-6. DOI: https://doi.org/10.1016/0002-9378(93)90043-I
Boregowda G, Shehata HA. Gastrointestinal and liver disease in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2013;27:835-53. DOI: https://doi.org/10.1016/j.bpobgyn.2013.07.006
Mayne ES, Mayne A, Louw S. Diagnosis of human immunodeficiency virus associated disseminated intravascular coagulation. PLoS ONE. 2022;17(1):e0262306. DOI: https://doi.org/10.1371/journal.pone.0262306
Ahmed KT, Almashhrawi AA, Rahman RN, Hammoud GM, Ibdah JA. Liver diseases in pregnancy: diseases unique to pregnancy. World J Gastroenterol. 2013;19(43):7639-46. DOI: https://doi.org/10.3748/wjg.v19.i43.7639
Downloads
Published
How to Cite
Issue
Section
