THE SAFETY AND EFFICACY OF GASTROINTESTINAL ENDOSCOPY DURING PREGNANCY

More than 12,000 pregnant patients in the United States per year have conditions normally evaluated by esophagogastroduodenoscopy (EGD). Mor e than 6000 pregnant patients in the United States per year have condi tions normally evaluated by sigmoidoscopy or colonoscopy. Endoscopy du ring pregnancy raises the unique issue of fetal safety, and endoscopic medications comprise a significant component of fetal risks from endo scopy. This article analyzes the safety of endoscopic medications duri ng pregnancy, reviews the literature on the safety of gastrointestinal endoscopy during pregnancy, proposes guidelines for endoscopic indica tions during pregnancy, and describes modifications of gastrointestina l endoscopy during pregnancy to increase fetal and maternal safety.