The following is a summary of “Megacolon Diagnosis in Pregnancy: A Case Report and Literature Review,” published in the July 2024 issue of Obstetrics and Gynecology by Guerra et al.
Megacolon, characterized by abnormal dilation of the colon without mechanical obstruction, presents rare but significant challenges during pregnancy due to potential maternal complications such as volvulus, ileus, bowel perforation, and systemic toxicity. These conditions can lead to severe morbidity and even mortality if not promptly diagnosed and managed. Obstetric outcomes are also affected, with risks including preterm birth, premature rupture of membranes, and dystocia, complicating the course of pregnancy.
In the reported case, a previously healthy nulliparous woman presented with a pelvic mass of significant size (>10 cm) discovered during a routine mid-trimester fetal ultrasound. The mass was observed to displace the gravid uterus, prompting suspicion of an underlying pathology. Further diagnostic work-up confirmed the diagnosis of megacolon, emphasizing the importance of thorough investigation in patients who are pregnant and presenting with unusual abdominal findings.
Managing megacolon during pregnancy necessitates a multidisciplinary approach involving obstetricians, gastroenterologists, and possibly surgical specialists. Treatment strategies must balance the need to alleviate symptoms and prevent complications while ensuring the safety of both the mother and fetus. Close monitoring and timely intervention are crucial to optimize outcomes, requiring careful consideration of the gestational stage and the severity of the condition.
Addressing chronic constipation, which can be exacerbated by pregnancy-related hormonal changes and increased intra-abdominal pressure, is essential during pre-conception and prenatal care. Healthcare providers should maintain a heightened awareness of such conditions, facilitating early detection and proactive management to mitigate risks and achieve favorable maternal and neonatal outcomes in pregnancies complicated by megacolon.
Source: sciencedirect.com/science/article/pii/S0301211524003518
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