Endoscopy is seldom required at the time of pregnancy. A list of potential risks of endoscopy during pregnancy includes exposure to radiation and foetal hypoxia due to sedative drugs. Studies in this area have shown that endoscopy during pregnancy is generally safe, and there is no evidence that endoscopy induces premature labour. However, there should be a vital requirement for the procedure during pregnancy, which should be deferred whenever possible to the second trimester. The endoscopy must be performed without anaesthesia or with the lowest dose of anaesthetic medication. Exposure to radiation during the procedure should also be kept to a minimum.
Why is the procedure performed?
An indication for endoscopy during pregnancy might arise due to the following reasons,
Sigmoidoscopy/colonoscopy: diarrhoea, rectal bleeding
Gastroscopy: dysphagia, uncontrolled nausea/vomiting, upper gastrointestinal bleeding
ERCP: choledocholithiasis, biliary pancreatitis. Sedative drugs, such as midazolam, appear safe if used carefully. Radiation exposure during ERCP can be kept well below the danger level for teratogenicity.
Although gastrointestinal (GI) endoscopy is usually safe, it is mandatory to evaluate the safety of this procedure during pregnancy. The best choice may be to delay the procedure until the third trimester or postpartum. GI endoscopy may be a safe alternative to surgical intervention or radiography in case therapeutic intervention is vital for particular clinical situations. Endoscopic Ultrasound in Yeshwanthpur, Bangalore is available at Manipal Hospitals, visit today.
The team of experts during the procedure
A team consisting of an obstetrician, endoscopist, and anaesthetist decide to perform an endoscopy on a pregnant patient as there are implications that this team of experts must analyse. There are implications for the mother, the foetus, the emergency of the situation and the possibility of therapeutic alternatives to solve the issue in safety conditions or postponement after labour. It is of utmost necessity for an obstetrician to be available during the procedure in case any complications related to the pregnancy arise.
Procedure risks on the pregnant woman
Possible risks of endoscopy for the pregnant woman include,
Hypotension through the compression of inferior vena cava
Precipitated aspiration through abdominal distension
Uterine trauma through the anatomic modification
Maternal hypotension appears through the compression of the inferior vena cava and the reduction of venous return. The supine position must be avoided during the procedures for this reason.
The pregnant uterus can compress abdominal organs and modify the digestive lumen. Therefore the duration of endoscopy can be extended. For the visualisation, a higher amount of air must be breathed; the endoscope can jump up (especially during colonoscopies) and can appear abdominal distension accompanied by discomfort in the pregnant woman.
Procedure risks on the foetus
A few risks for the foetus include oversedation leading to hypoxia, maternal position leading to foetal hyperperfusion, medicines administration leading to teratogenicity, uterine trauma, and the impact on the foetus through endoscopic trauma and preterm labour through uterine compression. It is therefore strongly advised to avoid undergoing endoscopies in the first trimester, except for clinical emergency cases. Book an appointment at our multi-speciality hospital today.
Among these risks, the potential risk of determining a malformation in foetal development through pill administration, early labour or mechanical uterine trauma needs evaluation when it is being analysed in an endoscopic procedure for pregnant people.