Postoperative intestinal paralysis in obstetric/gynecological practice

Upryamova E.Yu., Novikova S.V., Tsivtsivadze E.B.

Moscow Regional Research Institute of Obstetrics and Gynecology
Objective. To generalize and systematize recommendations for the prevention and correction of PIP in obstetric and gynecological practice on the basis of literature data and the authors’ own experience.
Materials and methods. The paper describes the results of a prospective analysis in 40 cases of PCP of varying severity in puerperas after cesarean section and long-term delivery.
Results. Based on the analysis, the authors identified main risk factors for PIP in obstetrics, gave recommendations for its prevention, and proposed an algorithm for the intensive therapy of PIP of varying severity.
Conclusion. To comply with the algorithm for the intensive therapy of PIP with the currently available prokinetics can achieve the regression of clinical and laboratory symptoms and prevent bowel obstruction.


postoperative intestinal paralysis
cesarean section
blood loss
risk factors
dynamic bowel obstruction


1. Hamilton B.E., Martin J.A., Ventura S.J. Births: preliminary data for 2012. Natl. Vital Stat. Rep. 2013; 62(3): 1-20.

2. Blumenfeld Y.J., El-Sayed Y.Y., Lyell D.J., Nelson L.M., Butwick A.J. Risk factors for prolonged postpartum length of stay following cesarean delivery. Am. J. Perinatol. 2015; 32(9): 825-32. doi: 10.1055/s-0034-1543953.

3. Bragg D., El-Sharkawy A.M., Psaltis E., Maxwell-Armstrong C., Lobo D.N. Postoperative ileus: Recent developments in pathophysiology and management. Clin. Nutr. 2015; 34(3): 367-76. doi: 10.1016/j.clnu.2015.01.016.

4. Abadi F., Shahabinejad M., Abadi F., Kazemi M. Effect of acupressure on symptoms of postoperative ileus after cesarean section. J. Acupunct. Meridian Stud. 2017; 10(2): 114-9. doi: 10.1016/j.jams.2016.11.008.

5. Sanfilippo F., Spoletini G. Perspectives on the importance of postoperative ileus. Curr. Med. Res. Opin. 2015; 31(4): 675-6. doi: 10.1185/03007995.2015.1027184.

6. Vather R., Trivedi S., Bissett I. Defining postoperative ileus: results of a systematic review and global survey. J. Gastrointest. Surg. 2013; 17(5): 962-72. doi: 10.1007/s11605-013-2148-y.

7. Pfeifer R., Lichte P., Schreiber H., Sellei R.M., Dienstknecht T., Sadeghi C. et al. Models of hemorrhagic shock: differences in the physiological and inflammatory response. Cytokine. 2013; 61(2): 585-90.

8. doi: 10.1016/j.cyto.2012.10.022.

9. Kim Y.S., Choi S.D., Bae D.H. Risk factors for complications in patients undergoing myomectomy at the time of cesarean section. J. Obstet. Gynaecol. Res. 2010; 36(3): 550-54.

10. Vather R., Bissett I.P. Risk factors for the development of prolonged post-operative ileus following elective colorectal surgery. Int. J. Colorectal Dis. 2013; 28(10): 1385-91. doi: 10.1007/s00384-013-1704-y.

11. Hsu Y.Y., Hung H.Y., Chang S.C., Chang Y.J. Early oral intake and gastrointestinal function after cesarean delivery: a systematic review and meta-analysis. Obstet. Gynecol. 2013; 121(6): 1327-34.

12. doi: 10.1097/AOG.0b013e318293698c.

13. Lobo D.N., Bostock K.A., Neal K.R., Perkins A.C., Rowlands B.J., Allison S.P. Effect of salt and water balance on recovery of gastrointestinal function after elective colonic resection: a randomised controlled trial. Lancet. 2002; 359(9320): 1812-8. doi: 10.1016/S0140-6736(02)08711-1.

14. Kronberg U., Kiran R.P., Soliman M.S., Hammel J.P., Galway U., Coffey J.C., Fazio V.W. A characterization of factors determining postoperative ileus after laparoscopic colectomy enables the generation of a novel predictive score. Ann. Surg. 2011; 253(1): 78-81. doi: 10.1097/SLA.0b013e3181fcb83e.

16. Соловьев И.А., Колунов А.В. Послеоперационный парез кишечника – проблема абдоминальной хирургии. Вестник Национального медико-хирургического Центра им. Н.И. Пирогова. 2013; 8(2): 112-8. [Solov’ev I.А., Kolunov А.V. Postoperative intestinal paresis is a problem of abdominal surgery. Vestnik Natsional’nogo mediko-khirurgicheskogo TSentra im. N.I. Pirogova 2013;8 (2):112-118. (in Russian)]

17. Agah J., Baghani R., Rakhshani M.H., Rad A. Metoclopramide role in preventing ileus after cesarean, a clinical trial. Eur. J. Clin. Pharmacol. 2015; 71(6): 657-62. doi:10.1007/s00228-015-1845-8.

18. Mawe G.M., Hoffman J.M. Serotonin signalling in the gut-functions, dysfunctions and therapeutic targets. Nat. Rev. Gastroenterol. Hepatol. 2013; 10(8): 473-86. doi: 10.1038/nrgastro.2013.105.

19. Государственный реестр лекарственных средств. Available at:

20. Овечкин А.М., Решетняк В.К. Использование длительной эпидуральной анальгезии для предупреждения операционного стресс-ответа и послеоперационных болевых синдромов. Боль. 2003; 1: 61-5. Available at:

Received 07.09.2018

Accepted 21.09.2018

About the Authors

Upryamova, Ekaterina Yu., MD, Head of Anesthesiology and Intensive Care Department, Moscow Regional Scientific Research Institute of Obstetrics and Gynecology,
101000, Russian Federation, Moscow, st. Pokrovka, 22a. ORCID:, e-mail: kvyalkova@gmailcom
Novikova, Svetlana V., MD, professor, Head of the Obstetrics Observatory Department Moscow Regional Scientific Research Institute of Obstetrics and Gynecology,
101000, Russian Federation, Moscow, st. Pokrovka, 22a. e-mail:
Tsivtsivadze, Ekaterina B., MD, Senior Researcher of the Obstetric Observatory Department Moscow Regional Scientific Research Institute of Obstetrics and Gynecology, 101000, Russian Federation, Moscow, st. Pokrovka, 22a. e-mail:

For citations: Upryamova E.Yu., Novikova S.V., Tsivtsivadze E.B. Postoperative intestinal paralysis in obstetric/gynecological practice. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (11): 159-64. (in Russian)

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