A systematic review of medical diagnosis of Ogilvie's syndrome in childbearing.

OBJECTIVE

to review all published papers examining medical diagnosis of Ogilvie's syndrome and pregnancy with a view to assessing the implications of the diagnosis and the condition itself for childbearing women, midwives and medical practitioners.

DESIGN

systematic review.

SEARCH STRATEGY

MEDLINE, CINAHL, EMBASE, Web of Science and Cochrane databases were searched from 1950 to 2006 inclusive. Papers were read by two independent researchers and selected if they informed the link between Ogilvie's syndrome and childbearing or were concerned with other aspects of maternal mortality.

FINDINGS

23 papers fulfilled the selection criteria and were of a suitable standard. Inconsistencies in relation to the diagnosis of Ogilvie's syndrome were noted, and an increase in maternal deaths from this condition was reported up to 2002.

KEY CONCLUSIONS

this paper highlights the strengths and weaknesses of medical diagnosis, as exemplified by Ogilvie's syndrome. The scientific basis of diagnoses such as Ogilvie's syndrome may deserve attention. This diagnosis has been shown to be unstable, both in temporal and aetiological terms. The midwifery and nursing reaction to the abrupt appearance of this condition is, at best, unfortunate. The attribution of blame to midwifery practices is deserving of a more robust response.

IMPLICATIONS FOR PRACTICE

there may be clinical implications of the diagnosis of Ogilvie's syndrome for other aspects of maternity (including any nursing) care. A particularly significant area is the widely recognised increase in the caesarean rate with which Ogilvie's syndrome has been closely linked.