Maternal and fetal outcomes of conscious sedation and endoscopy during pregnancy

V. J. Colon, Francisco C Ramirez, M. S. Cappell

Research output: Contribution to journalArticle

Abstract

The effects of conscious sedation during EGD upon pregnancy and the fetus are unknown. Objectives: To analyze the effects of conscious sedation to the pregnant patient and the fetus. Methods: Retrospective study of consecutive pregnant patients who received conscious sedation for EGD (sedation group). Pregnant patients undergoing EGD without conscious sedation were considered controls. Setting: Six teaching institutions. Study period: 1980 to 1996. Results: There were 37 patients in the sedation group and 11 in the control group. The mean gestation age at the time of endoscopy was 18.9 ±1.3 weeks. There were 11 (23%) patients in the first. 18 (37%) in the second and 19 (40%) in the third trimesters. Medications and their mean doses used for sedation included meperidine: 56.7±3.8 mg (26 patients), midazolam: 2.38±0.34 mg (17 patients), and diazepam: 5.11±0.97 mg (9 patients). Naloxone was used in 3 patients. No changes in blood pressure, heart rate or pulse oximetry were noted before or after the procedures in either group. No endoscopic complications occurred. The type of delivery (cesarean section versus normal vaginal delivery) was not affected by the use of conscious sedation. Pregnancy outcomes were not different between both groups. Group Weight at Birth (lbs) APGAR 1 min APGAR 5 min Excellent outcome* Sedation 5.9±0.6 8.13±0.3 8.7±0.3 23/28(82%) Control 6.5±0.7 8.5±0.2 9.1±0.1 8/8(100%) *12 patients excluded. 9 in the sedation (5 voluntary abortions and 4 unknown pregnancy outcomes) and 3 in the control group (unknown pregnancy outcome). Poor outcomes included 1 abortion and 4 stillbirths occurring in high risk pregnancies and unrelated to the EGD and/or sedation. In 4 cases with fetal heart monitoring, EGD did not induce rate abnormalities (pre-sedation: 142.5+3.9 beats/min; post-sedation=145.5+3.7 beats/min). Conclusions: 1) Conscious sedation did not induce hypotension, hypoxemia, or arrhythmias in the mother. 2) It did not have an adverse effect on fetal outcome. 3) This study suggests that conscious sedation with the medications and dosages used is not contraindicated in pregnancy.

Original languageEnglish (US)
JournalGastrointestinal Endoscopy
Volume45
Issue number4
StatePublished - 1997
Externally publishedYes

Fingerprint

Conscious Sedation
Endoscopy
Mothers
Pregnancy
Pregnancy Outcome
Fetus
Fetal Monitoring
High-Risk Pregnancy
Fetal Heart
Control Groups
Meperidine
Oximetry
Stillbirth
Midazolam
Third Pregnancy Trimester
Diazepam
Naloxone
Birth Weight
Cesarean Section
Hypotension

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Maternal and fetal outcomes of conscious sedation and endoscopy during pregnancy. / Colon, V. J.; Ramirez, Francisco C; Cappell, M. S.

In: Gastrointestinal Endoscopy, Vol. 45, No. 4, 1997.

Research output: Contribution to journalArticle

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abstract = "The effects of conscious sedation during EGD upon pregnancy and the fetus are unknown. Objectives: To analyze the effects of conscious sedation to the pregnant patient and the fetus. Methods: Retrospective study of consecutive pregnant patients who received conscious sedation for EGD (sedation group). Pregnant patients undergoing EGD without conscious sedation were considered controls. Setting: Six teaching institutions. Study period: 1980 to 1996. Results: There were 37 patients in the sedation group and 11 in the control group. The mean gestation age at the time of endoscopy was 18.9 ±1.3 weeks. There were 11 (23{\%}) patients in the first. 18 (37{\%}) in the second and 19 (40{\%}) in the third trimesters. Medications and their mean doses used for sedation included meperidine: 56.7±3.8 mg (26 patients), midazolam: 2.38±0.34 mg (17 patients), and diazepam: 5.11±0.97 mg (9 patients). Naloxone was used in 3 patients. No changes in blood pressure, heart rate or pulse oximetry were noted before or after the procedures in either group. No endoscopic complications occurred. The type of delivery (cesarean section versus normal vaginal delivery) was not affected by the use of conscious sedation. Pregnancy outcomes were not different between both groups. Group Weight at Birth (lbs) APGAR 1 min APGAR 5 min Excellent outcome* Sedation 5.9±0.6 8.13±0.3 8.7±0.3 23/28(82{\%}) Control 6.5±0.7 8.5±0.2 9.1±0.1 8/8(100{\%}) *12 patients excluded. 9 in the sedation (5 voluntary abortions and 4 unknown pregnancy outcomes) and 3 in the control group (unknown pregnancy outcome). Poor outcomes included 1 abortion and 4 stillbirths occurring in high risk pregnancies and unrelated to the EGD and/or sedation. In 4 cases with fetal heart monitoring, EGD did not induce rate abnormalities (pre-sedation: 142.5+3.9 beats/min; post-sedation=145.5+3.7 beats/min). Conclusions: 1) Conscious sedation did not induce hypotension, hypoxemia, or arrhythmias in the mother. 2) It did not have an adverse effect on fetal outcome. 3) This study suggests that conscious sedation with the medications and dosages used is not contraindicated in pregnancy.",
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N2 - The effects of conscious sedation during EGD upon pregnancy and the fetus are unknown. Objectives: To analyze the effects of conscious sedation to the pregnant patient and the fetus. Methods: Retrospective study of consecutive pregnant patients who received conscious sedation for EGD (sedation group). Pregnant patients undergoing EGD without conscious sedation were considered controls. Setting: Six teaching institutions. Study period: 1980 to 1996. Results: There were 37 patients in the sedation group and 11 in the control group. The mean gestation age at the time of endoscopy was 18.9 ±1.3 weeks. There were 11 (23%) patients in the first. 18 (37%) in the second and 19 (40%) in the third trimesters. Medications and their mean doses used for sedation included meperidine: 56.7±3.8 mg (26 patients), midazolam: 2.38±0.34 mg (17 patients), and diazepam: 5.11±0.97 mg (9 patients). Naloxone was used in 3 patients. No changes in blood pressure, heart rate or pulse oximetry were noted before or after the procedures in either group. No endoscopic complications occurred. The type of delivery (cesarean section versus normal vaginal delivery) was not affected by the use of conscious sedation. Pregnancy outcomes were not different between both groups. Group Weight at Birth (lbs) APGAR 1 min APGAR 5 min Excellent outcome* Sedation 5.9±0.6 8.13±0.3 8.7±0.3 23/28(82%) Control 6.5±0.7 8.5±0.2 9.1±0.1 8/8(100%) *12 patients excluded. 9 in the sedation (5 voluntary abortions and 4 unknown pregnancy outcomes) and 3 in the control group (unknown pregnancy outcome). Poor outcomes included 1 abortion and 4 stillbirths occurring in high risk pregnancies and unrelated to the EGD and/or sedation. In 4 cases with fetal heart monitoring, EGD did not induce rate abnormalities (pre-sedation: 142.5+3.9 beats/min; post-sedation=145.5+3.7 beats/min). Conclusions: 1) Conscious sedation did not induce hypotension, hypoxemia, or arrhythmias in the mother. 2) It did not have an adverse effect on fetal outcome. 3) This study suggests that conscious sedation with the medications and dosages used is not contraindicated in pregnancy.

AB - The effects of conscious sedation during EGD upon pregnancy and the fetus are unknown. Objectives: To analyze the effects of conscious sedation to the pregnant patient and the fetus. Methods: Retrospective study of consecutive pregnant patients who received conscious sedation for EGD (sedation group). Pregnant patients undergoing EGD without conscious sedation were considered controls. Setting: Six teaching institutions. Study period: 1980 to 1996. Results: There were 37 patients in the sedation group and 11 in the control group. The mean gestation age at the time of endoscopy was 18.9 ±1.3 weeks. There were 11 (23%) patients in the first. 18 (37%) in the second and 19 (40%) in the third trimesters. Medications and their mean doses used for sedation included meperidine: 56.7±3.8 mg (26 patients), midazolam: 2.38±0.34 mg (17 patients), and diazepam: 5.11±0.97 mg (9 patients). Naloxone was used in 3 patients. No changes in blood pressure, heart rate or pulse oximetry were noted before or after the procedures in either group. No endoscopic complications occurred. The type of delivery (cesarean section versus normal vaginal delivery) was not affected by the use of conscious sedation. Pregnancy outcomes were not different between both groups. Group Weight at Birth (lbs) APGAR 1 min APGAR 5 min Excellent outcome* Sedation 5.9±0.6 8.13±0.3 8.7±0.3 23/28(82%) Control 6.5±0.7 8.5±0.2 9.1±0.1 8/8(100%) *12 patients excluded. 9 in the sedation (5 voluntary abortions and 4 unknown pregnancy outcomes) and 3 in the control group (unknown pregnancy outcome). Poor outcomes included 1 abortion and 4 stillbirths occurring in high risk pregnancies and unrelated to the EGD and/or sedation. In 4 cases with fetal heart monitoring, EGD did not induce rate abnormalities (pre-sedation: 142.5+3.9 beats/min; post-sedation=145.5+3.7 beats/min). Conclusions: 1) Conscious sedation did not induce hypotension, hypoxemia, or arrhythmias in the mother. 2) It did not have an adverse effect on fetal outcome. 3) This study suggests that conscious sedation with the medications and dosages used is not contraindicated in pregnancy.

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