Table 2.
Second trimester fetal and maternal adverse events (wk 13–26)
| Indication | N | Maternal adverse events | Pregnancy outcome | Premature births | Other fetal adverse events | Temporal relation with endoscopy? | Etiological relation with endoscopy? |
|---|---|---|---|---|---|---|---|
| Sigmoidoscopy | |||||||
| IBD & colitis other [36-41] | 8 (in 6 pts) | None (n = 6) | Live birth (n = 5), not reported (n = 1) | Yes (n = 1), no (n = 4), not reported (n = 1) | Low birth weight (n = 2), not reported (n = 1) | No | No |
| Malignancy [42-47] | 6 | Maternal death (n = 2), unreported (n = 1), none (n = 3) | Live birth (n = 3), elective abortion (n = 2), fetal death (n = 1) | Yes (n = 3) all prostaglandin induced or elective caesarean section | Low birth weight (n = 3) | Yes (n = 3), no (n = 3) | Unlikely (n = 3) |
| Volvulus and incarcerated uterus [19,48,49] | 7 (in 5 pts) | None | Live birth (n = 5) | None | Low birth weight (n = 1) | No | No |
| Non-malignant colonic obstruction [50] | 1 | None | Live birth (n = 1) | Yes (n = 1) | Vaginal delivery at 35 wks | No | No |
| Gastrointestinal bleeding [51] | 1 | None | Stillbirth (n = 1) | Yes (n = 1) | Fetal demise at 20 wks within several hours of surgery | Yes | Possible, however the patient also underwent emergency surgery and suffered from a massive hemorrhage |
| Colonoscopy | |||||||
| IBD & colitis other [24,52-54] | 6 | None | Live birth (n = 5), stillbirth (n = 1) | Yes(n = 2), No (n = 4) | Unreported (n = 2), none (n = 4) | Unclear, paper fails to show which outcome belongs to which patient | Unclear, authors do not link adverse event (stillbirth) to endoscopy |
| Malignancy [55-60] | 6 | None (n = 3), maternal death postpartum (n = 2), disease progression postpartum (n = 1) | Live birth (n = 4), unreported (n = 1), fetal death at 26 wks(n = 1) | Yes (n = 3) at 30, 34 and 36 wks | Low birth weight (n = 3), neonatal care unit admittance postpartum (n = 2) | Yes, fetal death was within 1 week of colonoscopy, premature births no temporal relation with endoscopy | Probable, but fetal death most likely due to maternal deterioration because of cancer progression and sepsis |
| Volvulus and incarcerated uterus [61] | 1 | Not reported | Live birth (n = 1) | No | None | No | No |
| Non-malignant colonic obstruction [62] | 1 | Mother remained hospitalized for 50 days after delivery | Stillbirth (n = 1) | Yes (n = 1) | Evidence of spontaneous labour, physicians terminated the pregnancy at 15 wks | Yes | Probable, however colonic perforation was feared due to worsening distention of the bowel, not per se due to the LGE |
| Gastrointestinal bleeding [34,63] | 2 | None (n = 2) | Live birth (n = 1), not reported (n = 1) | No (n = 1), not reported (n = 1) | Not reported (n = 1), None (n = 1) | No | No |
| Total | 39 | ||||||