Gastrointestinal endoscopy in the pregnant woman

Table 6 Basic principles of endoscopy during pregnancy

1 Weigh benefits of endoscopy versus conservative management

2 Defer endoscopy to second trimester or post-delivery when appropriate

3 Evaluate all proposed medications in terms of teratogenicity and abortifacient potential

4 Obtain consultation from obstetrics and preferably employ anesthesiologist

5 Position patient on left side. Avoid perturbations of blood pressure

6 Minimize drug administration and procedure time

7 For ERCP, minimize or obviate radiation (Table 5). Utilize radiation physicist and calculate dosimetry

8 Utilize bipolar electrocautery. Minimize monopolar use

ERCP: Endoscopic retrograde cholangiopancreatography.