Document Detail


Safety and efficacy of ERCP in pregnancy.
MedLine Citation:
PMID:  15278066     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Choledocholithiasis during pregnancy increases the risk of morbidity and mortality for both fetus and mother because of cholangitis and pancreatitis. ERCP has been advocated as safe and effective in pregnant women, but fetal radiation exposure is not routinely monitored. The aim of this study was to record fetal exposure to ionizing radiation during ERCP and to assess outcome. METHODS: Seventeen ERCPs were performed in pregnant women between January 1995 and August 2003. Techniques to minimize fluoroscopy were used, and fluoroscopy times were recorded. Thermoluminescent dosimeters affixed to the skin of the mother were used to estimate fetal radiation exposure. OBSERVATIONS: Mean gestational age was 18.6 (8.9) weeks (range 5-33 weeks). Mean fluoroscopy time was 14 (13) seconds (range 1-48 seconds). Estimated fetal radiation exposure was 40 (46) mrad (range 1-180 mrad). There was a correlation between fluoroscopy time and radiation exposure, but there was a wide range of radiation exposure for individual fluoroscopy times. Complications included post-sphincterotomy bleeding in one patient (controlled by hemoclip placement) and post-ERCP pancreatitis in one patient that necessitated 3 days of hospitalization. Two women developed third-trimester preeclampsia, and labor was induced in both. Thirteen of the 15 patients who delivered were contacted and they confirmed that their child was in good health. CONCLUSIONS: ERCP with modified techniques is safe during pregnancy. Dosimetry should be routinely recorded.
Authors:
Michel Kahaleh; Gary D Hartwell; Kristen O Arseneau; Thomas N Pajewski; Tarun Mullick; Gulkan Isin; Suresh Agarwal; Paul Yeaton
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  60     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-07-27     Completed Date:  2004-11-09     Revised Date:  2005-07-19    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  287-92     Citation Subset:  IM    
Affiliation:
Digestive Health Center, Radiation Oncology Physics, Department of Anesthesiology, University of Virginia Health System, Charlottesville, VA 22908, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cholangiopancreatography, Endoscopic Retrograde*
Choledocholithiasis / radiography*
Female
Fetus / radiation effects*
Fluoroscopy
Humans
Pregnancy
Pregnancy Complications / radiography*
Pregnancy Outcome*
Radiation Dosage
Retrospective Studies
Comments/Corrections
Comment In:
Gastrointest Endosc. 2005 Feb;61(2):352-3; author reply 353   [PMID:  15729268 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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