There is no agreed treatment strategy for patients presenting
with SBO in pregnancy. Optimal management
depends on a number of factors including aetiology of the
obstruction and gestational age of the fetus. As with the
non-pregnant patient, if the aetiology is a volvulus or
internal hernia, then the treatment of choice is surgery.
However, with adhesional SBO, the management is less
clear cut. Based on the contemporary literature and our
own personal experience, we recommend the strategy in
Figure 2. While in agreement with previous literature
reviews regarding the need for prompt laparotomy in
most cases of SBO, the contemporary literature and our
own experience suggest that patients with confirmed
adhesional obstruction may be managed conservatively in
the first instance but with a low threshold for progressing
to laparotomy.