Gastrointestinal endoscopy in pregnancy.
Gastrointestinal endoscopy has a major diagnostic and therapeutic role in most gastrointestinal disorders; however, limited information is available about clinical efficacy and safety in pregnant patients. The major risks of endoscopy during pregnancy include potential harm to the fetus because of hypoxia, premature labor, trauma and teratogenesis. In some cases, endoscopic procedures may be postponed until after delivery. When emergency or urgent indications are present, endoscopic procedures may be considered with some precautions. United States Food and Drug Administration category B drugs may be used in low doses. Endoscopic procedures during pregnancy may include upper gastrointestinal endoscopy, percutaneous endoscopic gastrostomy, sigmoidoscopy, colonoscopy, enteroscopy of the small bowel or video capsule endoscopy, endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography. All gastrointestinal endoscopic procedures in pregnant patients should be performed in hospitals by expert endoscopists and an obstetrician should be informed about all endoscopic procedures. The endoscopy and flexible sigmoidoscopy may be safe for the fetus and pregnant patient, and may be performed during pregnancy when strong indications are present. Colonoscopy for pregnant patients may be considered for strong indications during the second trimester. Although therapeutic endoscopic retrograde cholangiopancreatography may be considered during pregnancy, this procedure should be performed only for strong indications and attempts should be made to minimize radiation exposure.
Nurten Savas, Department of Gastroenterology, Baskent Universitesi Hastanesi, 06990 Istanbul, Turkey.
Nurten
N
Savas
D000700:Analgesics / Q000009:adverse effects; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D004066:Digestive System Diseases / Q000175:diagnosis* / Q000628:therapy*; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects; D019160:Endosonography / Q000009:adverse effects; D005260:Female; D005333:Fetus / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D018579:Patient Selection; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000628:therapy*; D049188:Prenatal Injuries / Q000209:etiology; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal / Q000009:adverse effects / Q000379:methods*
D000700:Analgesics; D006993:Hypnotics and Sedatives
Colonoscopy; Endoscopic retrograde cholangiopancreatography; Endoscopy; Pregnancy; Safety