Large bowel obstruction during pregnancy: the efficacy of dietary fibers
Yu.E. Dobrokhotova, E.I. Borovkova, T.D. Simonyan, D.S. Selimshaeva
Pirogov Russian National Research Medical University, Moscow, Russian Federation
Aim: to evaluate the clinical efficacy of dietary fibers and lactulose in pregnant women with large bowel obstruction.
Patients and Methods: this prospective study included 60 pregnant women (20–24 weeks of pregnancy) with large bowel obstruction occurred during pregnancy and persisted for at least 3 months. All women were randomized and divided into two groups. Group 1 received soluble fibers and group 2 received group 2 received lactulose. Clinical efficacy of treatment was evaluated using a specialized questionnaire filled at baseline, 48 h, 4 days, and 14 days after starting treatment.
Results: mean age was 27.1±4.0 years in group 1 and 28.3±5.0 years in group 2. Bowel evacuation less than 3 times a week occurred in 87% and 77%, respectively, the duration of pushing occupied more than 25% of defecation in 70% and 60%, respectively, hard stool occurred in 100%, anal fissures and a feeling of incomplete evacuation were reported in 47% and 57%, respectively. Comfort bowel evacuation 48 h after starting treatment was reported in 63% of women who received dietary fibers and 47% of patients who received lactulose. Normal defecation by day 4 was observed in 80% of women in group 1 and 53% in group 2. Treatment effect was achieved by day 14 in 87% in group 1 and 70% in group 2. The most common complaint was abdominal distension that occurred 3.5 times more common after treatment with lactulose (р<0.05).
Conclusions: dietary fibers were more effective in terms of achieving the desired outcome and patient satisfaction.
Keywords: large bowel obstruction, defecation, pregnancy, dietary fibers, OptiFibere, lactulose.
For citation: Dobrokhotova Yu.E., Borovkova E.I., Simonyan T.D., Selimshaeva D.S. Large bowel obstruction during pregnancy: the efficacy of dietary fibers. Russian Journal of Woman and Child Health. 2021;4(1):36–41. DOI: 10.32364/2618-8430-2021-4-1-36-41.
Acknowledgment
Editorial Board is grateful to Atrium Innovations for the assistance in technical edition of this publication.
About the authors:
Yuliya E. Dobrokhotova — Doct. of Sci. (Med.), professor, Head of the Department of Obstetrics & Gynecology of the Medical Faculty, Pirogov Russian National Research Medical University; 1, Ostrovityanov str., Moscow, 117437, Russian Federation; ORCID iD 0000-0002-7830-2290.
Ekaterina I. Borovkova — Doct. of Sci. (Med.), professor of the Department of Obstetrics & Gynecology of the Medical Faculty, Pirogov Russian National Research Medical University; 1, Ostrovityanov str., Moscow, 117437, Russian Federation; ORCID iD 0000-0001-7140-262X.
Tat'yana D. Simonyan — clinical resident of the Department of Obstetrics & Gynecology of the Medical Faculty, Pirogov Russian National Research Medical University; 1, Ostrovityanov str., Moscow, 117437, Russian Federation.
Dinara S. Selimshaeva — clinical resident of the Department of Obstetrics & Gynecology of the Medical Faculty, Pirogov Russian National Research Medical University; 1, Ostrovityanov str., Moscow, 117437, Russian Federation.
Contact information: e-mail: Ekaterina I. Borovkova, Katyanikitina@mail.ru. Financial Disclosure: no authors have a financial or property interest in any material or method mentioned. There is no conflict of interests. Received 01.12.2020, revised 24.12.2020, accepted 20.01.2021.
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