Professional Documents
Culture Documents
Division
Constipacy in pregnancy
a review from RCOG April
2015
Presenter
Dr. Roza Maulindra
Moderator
Dr. Hj. Putri Mirani, SpOG(K)
Learning Objectives
To
understand
the
prevalence
and
Ethical Issue
Introduction
Secondary
constipation
results
from
either
Information
on
bowel
dysfunction
during
pregnancy is limited
classification for
(Table 1).
chronic
constipation
Pathophysiology
Clinical Evaluation
Evaluate from its symptoms:
Evacuating infrequently
Excessive
straining
pudendal
nerve
weakening
pelvic floor
Treatment
1. Bulk-forming agents
Relive constipation by bulking facal mass
thereby stimulating peristalsis
Not absorb in GI tract
No adverse effect to fetus
Slowly act
Not effective in acute
Contraindicated to faecal impaction
Eq: Wheat bran, isphagula husk,
methylcellulose, sterculia
2. Osmotic laxative
2. Osmotic laxative
Side
effect:
flatulence
and
abdominal
Macrogols
(like
Movicol,
Middlesex,
UK)
are
inert
Norgine
Ltd.,
polymers
of
3. Stimulant laxative
Senna
is
partially
absorbed
gastrointestinal tract.
from
the
3. Stimulant laxative
4. New agents
altering
colonic
motility
4. New agents
Linaclotide
is
guanylate
cyclase-C
receptor
the
concentration
monophosphate
of
(c-GMP)
extracellular
reduce
cyclic
visceral
guanosine
pain
by
4. New agents
5. Suppositories and
enemas
laxatives
can
be
withdrawn
gradually
Conclusion
women
with
constipation
in
pregnancy
effectively
Rectal bleeding.
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