Constipation in pregnancy - a systematic review

• Autor(a) principal: Matos, Ana Sofia Rocha de
• Data de Publicação: 2014
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.6/4867
• topic: Diagnóstico; Gravidez; Obstipação; Prevalência; Tratamento; Domínio/Área Científica::Ciências Médicas::Ciências da Saúde::Medicina

Constipation during pregnancy is a common problem. It usually does not require an extensive evaluation and most patients respond to simple measures. Treatment typically consists of dietary measures, such as increasing fiber and fluid intake, behavioral changes, such as physical activity, and the use of probiotics or laxatives. However, the diagnosis of constipation itself is difficult to define and may vary from doctor to doctor. This systematic review aimed to identify the diagnostic criteria of constipation during pregnancy, its prevalence during the three trimesters, as well as the effects and efficacy of different interventions for its prevention or treatment. The survey included items available electronically, using databases such as Pubmed, B -on, RCAAP, UBI catalog, Springer, COCHRANE, Current Opinion in Obstetrics & Gynecology, Green Journal of Obstetrics & Gynecology, SciELO, EMBASE and EBSCO, and also manual research on textbooks of reference considered relevant to the topic. Despite its clinical relevance, there are few quality studies on gastrointestinal transit in pregnant women, identification and treatment of constipation during pregnancy. The present review concludes that the prevalence of constipation is higher during the second trimester of pregnancy and lower in the third, constituting the Rome III criteria the more acceptable definition. Regarding constipation treatment, during pregnancy abundant fluid intake was associated with a lower prevalence, whereas there is no evidence that dietary fiber and physical activity improve constipation. On the contrary, both the use of probiotics and an electrolyte solution of polyethylene glycol, an osmotic laxative, appear to be effective treatments, but there is insufficient evidence about its effects, therefore subsequent studies may be needed to safely recommend these treatments. Finally, stimulant laxatives may be more effective than bulk-forming laxatives, although adverse effects such as abdominal pain and diarrhea, may limit their use. However, this conclusion is based on an old and very low quality study. In conclusion: despite the importance of the theme there are no quality studies that support grounded proposals on prevention and treatment of constipation during pregnancy.