A MULTICENTER, MULTIYEAR STUDY OF THE SAFETY AND CLINICAL UTILITY OF ESOPHAGOGASTRODUODENOSCOPY IN 20 CONSECUTIVE PREGNANT FEMALES WITH FOLLOW-UP OF FETAL-OUTCOME

Objectives: To analyze the risks versus benefits of panendoscopy to th e pregnant female and fetus. Methods: Retrospective study of 20 consec utive pregnant patients admitted to three university teaching hospital s during 71/2 yr who underwent panendoscopy. Results: Indications for panendoscopy included hematemesis in eight, vomiting and abdominal pai n in five, vomiting in four, abdominal pain in two, and melena without hematemesis in one. Six patients were in the first trimester of pregn ancy, eight were in the second trimester, and six were in the third tr imester. Fourteen patients (70%) had a lesion diagnosed by panendoscop y, including esophagitis in seven, duodenal ulcer in two, gastritis in three, and Mallory-Weiss tear in two. In particular, all nine patient s (100%) with gastrointestinal bleeding had a lesion identified by eso phagogastroduodenoscopy. No significant endoscopic complications occur red. Panendoscopy did not induce labor in any patient. Fetal outcome w as ascertained in 19 (95%) of the pregnancies. Seventeen infants were delivered at full term. Two were delivered at 33 and 35 weeks of gesta tion. No infant had a congenital malformation noted in the neonatal nu rsery. The mean infant Apgar scores were 8.2 +/- 1.3 (SD) at 1 min, an d 9.1 +/- 0.3 (SD) at 5 min. Conclusions: In this study of 20 pregnanc ies, panendoscopy did not induce labor or result in congenital malform ations. Panendoscopy is not absolutely contraindicated during pregnanc y. Panendoscopy appears to be beneficial in medically stable pregnant patients with significant gastrointestinal bleeding. Panendoscopy shou ld be performed with monitoring by electrocardiography and pulse oxime try after stabilization of vital signs, which may require transfusion of blood products and supplemental oxygen administration.