A multicenter, multiyear study of the safety and clinical utility of esophagogastroduodenoscopy in 20 consecutive pregnant females with follow-up of fetal outcome.

Abstract

To analyze the risks versus benefits of panendoscopy to the pregnant female and fetus. Retrospective study of 20 consecutive pregnant patients admitted to three university teaching hospitals during 7 1/2 yr who underwent panendoscopy. Indications for panendoscopy included hematemesis in eight, vomiting and abdominal pain in five, vomiting in four, abdominal pain in two, and melena without hematemesis in one. Six patients were in the first trimester of pregnancy, eight were in the second trimester, and six were in the third trimester. Fourteen patients (70%) had a lesion diagnosed by panendoscopy, including esophagitis in seven, duodenal ulcer in two, gastritis in three, and Mallory-Weiss tear in two. In particular, all nine patients (100%) with gastrointestinal bleeding had a lesion identified by esophagogastroduodenoscopy. No significant endoscopic complications occurred. Panendoscopy did not induce labor in any patient. Fetal outcome was ascertained in 19 (95%) of the pregnancies. Seventeen infants were delivered at full term. Two were delivered at 33 and 35 weeks of gestation. No infant had a congenital malformation noted in the neonatal nursery. The mean infant Apgar scores were 8.2 +/- 1.3 (SD) at 1 min, and 9.1 +/- 0.3 (SD) at 5 min. In this study of 20 pregnancies, panendoscopy did not induce labor or result in congenital malformations. Panendoscopy is not absolutely contraindicated during pregnancy. Panendoscopy appears to be beneficial in medically stable pregnant patients with significant gastrointestinal bleeding. Panendoscopy should be performed with monitoring by electrocardiography and pulse oximetry after stabilization of vital signs, which may require transfusion of blood products and supplemental oxygen administration.