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| |  Colonoscopy Appears Safe to Foetus: Presented at ACG By Danny Kucharsky PHILADELPHIA, PA. -- October 23, 2007 -- Colonoscopy during pregnancy, when strongly indicated, may be very beneficial to the mother and the foetus by diagnosing and initiating treatment for serious gastrointestinal disorders, according to a study presented here at the American College of Gastroenterology (ACG) Annual Scientific Meeting. The retrospective study presented October 14 analysed the safety of colonoscopy, including data on foetal outcome, in pregnant women. Lead investigator Steven Fox, MD, Department of Gastroenterology at the William Beaumont Hospital, Royal Oak, Michigan, United States, noted that every year more than 6,000 pregnant women in the U.S. have a strong indication for either sigmoidoscopy or colonoscopy. However, the safety of colonoscopy during pregnancy has been inadequately studied, with only 15 previously reported cases. A total of 23 patients underwent colonoscopy during pregnancy at Dr. Fox's institution between 1986 and 2006. Patients' mean age was 29.7 years (range 20 to 38 years) and the mean gestational age at colonoscopy was 17.9 weeks, with a range from 2 to 33 weeks. Four patients had colonoscopy during the first trimester, 16 in the second trimester, and three in the third trimester. Mean duration of endoscopy was 19.4 minutes (range 8-45 minutes). The procedure was well tolerated in 78% of patients. Primary indications for colonoscopy included haematochezia in 10 patients, diarrhoea in four, foreign body in one, and other reasons in eight. Major new findings or therapy included new ulcerative colitis in three, haemorrhoids in three, ischaemic colitis in three, established inflammatory bowel disease in two, foreign body removal in one, new Crohn's disease in one, and other in one. Six patients had a normal colonoscopy. Patients were hospitalised for 2.6 days (range 0-20) after index colonoscopy. Maternal colonoscopy complications include hypotension in three patients and minor symptoms in six. Two patients had spontaneous abortions (both in the first trimester; 5 days and 5 weeks after colonoscopy). All other infants were delivered alive with no congenital malformations noted. Mean age of gestation at delivery was 37.8 weeks (n=19, range 33-40). Foetal outcomes included low birth weight (< 2500 grams) in two infants, twin gestation in one and premature delivery (<37 weeks) in nine. "There are many theoretical risks to the foetus from colonoscopy," Dr. Fox said, including placental abruption from endoscopic intubation, hypotension, hypoxia and cardiac arrhythmias. However, colonoscopy may help prevent patients from receiving unneeded medications and radiation exposure. As well, colonoscopy may help stop gastrointestinal bleeding. Dr. Fox concluded that colonoscopy appears to be relatively safe and may be performed when indicated during the second and third trimesters of pregnancy.
[Presentation title: Safety of Colonoscopy During Pregnancy. Abstract 100]
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