Kamani Lubna, Achakzai Muhammad S, Ismail Faisal Wasim, Kayani Farhana
Gastroenterology, Liaquat National Hospital & Medical College, Karachi, PAK.
Gastroenterology, Bolan Medical College, Quetta, PAK.
Cureus. 2019 Dec 5;11(12):e6301. doi: 10.7759/cureus.6301.
Gastrointestinal (GI) endoscopy is an important tool for diagnosis and treatment of GI diseases. However, when endoscopy is indicated during pregnancy, concerns about its safety for mother and fetus often arise. Our objective was to evaluate the safety and efficacy of endoscopic procedures in pregnant patients along with maternal and fetal outcomes.
This study was conducted at the Aga Khan University Hospital after Ethics review committee approval. It was a retrospective study and medical records of all pregnant patients who underwent endoscopy during pregnancy from January 2000 to January 2014 were analyzed. Data regarding the indications and type of endoscopic procedure, use of sedation and radiation were noted; data on any complications during or after pregnancy were recorded as well.
A total of 48 pregnant women underwent endoscopic procedures. Procedures that were performed included gastroscopy, sigmoidoscopy, colonoscopy, and endoscopic retrograde cholangio-pancreaticography (ERCP) in 28, 15, 1, and 4 patients, respectively. The major indication for gastroscopy was hematemesis in 16 procedures (57.14%) and screening for esophageal varices was done in 10 (21.42%). The indications of ERCP were choledocholithiasis and cholangitis. However, bleeding per rectum was the main indication for sigmoidoscopy and colonoscopy. Some 34 (70.83%) procedures were diagnostic and the rest were therapeutic. Only one patient had a miscarriage in second trimester.
Endoscopic procedures are safe to be performed in pregnant patients in the presence of strong indications without posing major risk to the mother or the fetus. However, further prospective multicenter research studies are strongly recommended.
胃肠内镜检查是诊断和治疗胃肠疾病的重要工具。然而，当在孕期需要进行内镜检查时，人们常常会担心其对母亲和胎儿的安全性。我们的目的是评估孕妇内镜检查操作的安全性和有效性以及母婴结局。
本研究在阿迦汗大学医院进行，经伦理审查委员会批准。这是一项回顾性研究，分析了2000年1月至2014年1月期间所有孕期接受内镜检查的孕妇的病历。记录了内镜检查操作的指征和类型、镇静剂及辐射的使用情况；还记录了孕期期间或之后的任何并发症数据。
共有48名孕妇接受了内镜检查操作。所进行的操作分别包括28例胃镜检查、15例乙状结肠镜检查、1例结肠镜检查和4例内镜逆行胰胆管造影（ERCP）。胃镜检查的主要指征是16例（57.14%）呕血，10例（21.42%）进行了食管静脉曲张筛查。ERCP的指征是胆总管结石和胆管炎。然而，直肠出血是乙状结肠镜检查和结肠镜检查的主要指征。约34例（70.83%）操作是诊断性的，其余为治疗性的。只有一名患者在孕中期流产。
在有强烈指征的情况下，对孕妇进行内镜检查操作是安全的，不会对母亲或胎儿构成重大风险。然而，强烈建议进一步开展前瞻性多中心研究。
