Document Detail


Safety and efficacy of colonoscopy during pregnancy: an analysis of pregnancy outcome in 20 patients.
MedLine Citation:
PMID:  20506671     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To analyze maternal and fetal safety of colonoscopy during pregnancy. STUDY DESIGN: Retrospective study comparing fetal outcomes at 2 hospitals from 1986 to 2007 of 20 pregnant women undergoing colonoscopy vs. 20 matched pregnant controls not undergoing colonoscopy. RESULTS: Colonoscopic indications included diarrhea (8), hematochezia (4), bloody diarrhea (3), abdominal pain (2) and other (3). Colonoscopy was performed during the first trimester in 2, second trimester in 16 and third trimester in 2. Colonoscopic intubation was to cecum (11), hepatic flexure (2) and transverse colon (7). Excluding 1 successful therapeutic colonoscopy, colonoscopy was diagnostic in 10 of 19 cases, including ulcerative colitis (5), ischemic colitis (2), Crohn's colitis (2) and lymphocytic colitis (1). Colonoscopy led to therapeutic changes in 7 (35%). Two minor maternal procedural complications occurred (mild, transient hypotension). No fetal distress was detected during colonoscopy by fetal heart rate monitoring in 6 patients. Study patients had 1 involuntary abortion and 1 infant born with congenital defects; all other infants were born relatively healthy. Study patients had similar or lower rates than controls of these unfavorable fetal outcomes: involuntary abortion, premature delivery, low birth weight, congenital defects, neonatal ICU stay, infant postpartum hospitalization > or = 4 days and infant death after live birth. Study infants had similar or higher mean Apgar scores vs. controls at 1 and 5 minutes. CONCLUSION: Pregnant patients undergoing colonoscopy tended to have better, but not statistically significant, fetal outcomes than matched pregnant controls not undergoing colonoscopy. Colonoscopy may be relatively safe, without large fetal risks, during the second trimester and may improve fetal outcome. Colonoscopy may be performed when strongly indicated during the second trimester.
Authors:
Mitchell S Cappell; Steven R Fox; Navakanth Gorrepati
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  55     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:    2010 Mar-Apr
Date Detail:
Created Date:  2010-05-28     Completed Date:  2010-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  115-23     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology, Department of Medicine, William Beaumont Hospital, Royal Oak, Michigan 48073, USA. mscappell@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Case-Control Studies
Colitis / diagnosis
Colonic Pseudo-Obstruction / therapy
Colonoscopy*
Female
Humans
Pregnancy
Pregnancy Complications / diagnosis,  therapy
Pregnancy Outcome*
Pregnancy Trimesters
Retrospective Studies

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


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