Bowel Complications following Caesarean Birth

Acute colonic pseudo-obstruction (ACPO) following caesarean birth is a serious but rare complication that can lead to bowel perforation, emergency surgery, and significant maternal morbidity. Despite this, bowel outcomes have never been examined in randomised trials comparing interventions during caesarean birth. Our preliminary service evaluation of nearly 7,000 caesarean births over three years found a stable ileus rate of 4% but a tenfold increase in ACPO. This increase included a fivefold rise in cases requiring colonoscopic decompression or surgery, outcomes that cannot be explained by changes in diagnostic practice alone.

This project will strengthen these preliminary findings through individual-level chart review of all affected cases and electronic health record analysis of the full cohort, aiming to indentify explanations and plan mitigation strategies.