Division of Gastroenterology & Hepatology, MOB 233, William Beaumont Hospital, Royal Oak, MI 48073, USA.
Nat Rev Gastroenterol Hepatol. 2011 Oct 4;8(11):610-34. doi: 10.1038/nrgastro.2011.162.
Although gastrointestinal endoscopy is generally safe, its safety must be separately analyzed during pregnancy with regard to fetal safety. Fetal risks from endoscopic medications are minimized by avoiding FDA category D drugs, minimizing endoscopic medications, and anesthesiologist attendance at endoscopy. Esophagogastroduodenoscopy seems to be relatively safe for the fetus and may be performed when strongly indicated during pregnancy. Despite limited clinical data, endoscopic banding of esophageal varices and endoscopic hemostasis of nonvariceal upper gastrointestinal bleeding seems justifiable during pregnancy. Flexible sigmoidoscopy during pregnancy also appears to be relatively safe for the fetus and may be performed when strongly indicated. Colonoscopy may be considered in pregnant patients during the second trimester if there is a strong indication. Data on colonoscopy during the other trimesters are limited. Therapeutic endoscopic retrograde cholangiopancreatography seems to be relatively safe during pregnancy and should be performed for strong indications (for example, complicated choledocholithiasis). Endoscopic safety precautions during pregnancy include the performance of endoscopy in hospital by an expert endoscopist and only when strongly indicated, deferral of endoscopy to the second trimester whenever possible, and obstetric consultation.
虽然胃肠内窥镜检查通常是安全的，但在考虑胎儿安全时，必须单独分析其在怀孕期间的安全性。通过避免 FDA 类别 D 药物、尽量减少内窥镜药物和麻醉师在内窥镜检查时的参与，可以将内窥镜药物对胎儿的风险降至最低。食管胃十二指肠镜检查对胎儿似乎相对安全，并且在怀孕期间有强烈指征时可以进行。尽管临床数据有限，但在怀孕期间对食管静脉曲张进行内镜套扎和对上消化道非静脉曲张性出血进行内镜止血似乎是合理的。在怀孕期间进行软性乙状结肠镜检查对胎儿也似乎相对安全，并且在有强烈指征时可以进行。如果有强烈指征，可考虑在怀孕中期对患者进行结肠镜检查。其他孕期的结肠镜检查数据有限。如果有强烈指征，治疗性内镜逆行胰胆管造影术在怀孕期间似乎相对安全，应进行治疗（例如，复杂的胆管结石）。怀孕期间的内镜安全预防措施包括由专家内镜医生在医院进行内镜检查，并且只有在有强烈指征时才进行，尽可能将内镜检查推迟到孕中期，并咨询产科医生。
