Division of Gastroenterology, Department of Medicine, University of California San Francisco, Myung Ko. 1701 Divisadero St, Ste 120, San Francisco, CA, 94115, USA.
Bakar Computational Health Sciences Institute, University of California, San Francisco, CA, USA.
Dig Dis Sci. 2020 Oct;65(10):2979-2985. doi: 10.1007/s10620-020-06122-8. Epub 2020 Feb 7.
Lower gastrointestinal endoscopy is crucial in the diagnosis and staging of inflammatory bowel disease (IBD). However, there are limited safety data in pregnant populations, resulting in conservative society guidelines and practice patterns favoring diagnostic delay. We studied whether performance of flexible sigmoidoscopy is associated with adverse events in pregnant patients with known or suspected IBD.
A retrospective cohort study was conducted at the University of California San Francisco (UCSF) between April 2008 and April 2019. Female patients aged between 18 and 48 years who were pregnant at the time of endoscopy were identified. All patient records were reviewed to determine disease, pregnancy outcomes, and lifestyle factors. Two independent reviewers performed the data abstraction. Adverse events were assessed for temporal relation with endoscopy.
We report the outcomes of 48 pregnant patients across all trimesters who underwent lower endoscopy for suspected or established IBD. There were no hospitalizations or adverse obstetric events temporally associated with sigmoidoscopy. 78% (38/50) of lower endoscopies performed in the patients resulted in a change in treatment following sigmoidoscopy. 12% (5/43) of the lower endoscopies performed in patients with known IBD showed no endoscopic evidence of disease activity despite symptoms.
Lower endoscopy in the pregnant patient with known or suspected IBD is low risk and affects therapeutic decision making. It should not be delayed in patients with appropriate indications.
下消化道内镜检查对于炎症性肠病（IBD）的诊断和分期至关重要。然而，在孕妇人群中，安全性数据有限，导致社会指南和实践模式保守，倾向于延迟诊断。我们研究了在已知或疑似 IBD 的孕妇中进行软性乙状结肠镜检查是否与不良事件相关。
这是一项在加利福尼亚大学旧金山分校（UCSF）进行的回顾性队列研究，时间为 2008 年 4 月至 2019 年 4 月。确定了在进行内镜检查时怀孕的年龄在 18 至 48 岁之间的女性患者。回顾了所有患者的记录，以确定疾病、妊娠结局和生活方式因素。两名独立的审查员进行了数据提取。评估了不良事件与内镜检查的时间关系。
我们报告了在所有孕期接受下消化道内镜检查以怀疑或确诊 IBD 的 48 名孕妇的结果。没有与乙状结肠镜检查时间相关的住院或不良产科事件。在 50 例患者中，78%（38/50）的下消化道内镜检查结果改变了治疗方案。在已知 IBD 的 43 例患者中，12%（5/43）的下消化道内镜检查尽管有症状，但没有内镜疾病活动的证据。
对于已知或疑似 IBD 的孕妇，下消化道内镜检查风险低，且会影响治疗决策。对于有适当指征的患者，不应该延迟进行。
