GASTROENTEROLOGY ARTICLE OF THE WEEK
May 5, 2005
ASGE. ASGE Guideline: Guidelines for endoscopy in pregnant and lactating women. Gastrointest Endosc 2005;61:357-62.
1. ERCP during pregnancy
a. should never be done
b. hard copy X-rays should not be obtained
c. placing appropriate shields over the uterine area should be sufficient to
minimize radiation exposure
d. Keep radiation exposure to the uterine area below 5-10 rads.
True or false
2. Pregnant patients should be supine rather than on the left lateral decubitus position when undergoing EGD.
3. Diazepam is safer than midazolam for sedation during pregnancy.
4. The grounding pad for electrocautery should be placed away from the uterus.
5. Epinephrine injections for bleeding control are completely safe during pregnancy.
6. When possible, endoscopy should be deferred to the second trimester.
7. Nursing a baby should be avoided for at least 4 hours after receiving midazolam.
8. Propofol admistered by an anesthesiologist may be the ideal premedication for pregnant patients, as it is category B; nursing should be avoided for an specified period of time after administration.
9. Meperidine alone, without diazepam or midazolam is preferred; if needed, small doses of midazolam can be used.
10. Fentanyl is probably the best sedative for patients who are lactating.
11. Quinolones cannot be used during pregnancy, but are safe in lactating patients.