Endoscopic Retrograde Cholangiopancreatography: safety and acceptance in pregnancy

To evaluate the indications, clinical features, safety in sedation, complications and minimum use of radiation during endoscopic retrograde cholangiopancreatography in pregnant patients of varying trimesters, a prospective case series was conducted at the endoscopy suite, Surgical Unit 4, Civil Hospital Karachi, from January 2007 to June 2011. Acquiring the desired goal through endoscopic therapy was considered technical success. A total of 10 pregnant women (mean age 25.5±4.8 years) underwent 11 ERCP procedures. Three (30%) patients were in the first trimester, 4 (40%) in the second trimester, and 3 (30%) in the third trimester. Of the 10 women, 4 (40%) were primigravida and six (60%) multigravida. Mean fluoroscopy time was 6.5±1.7 seconds. Technically successful endoscopic therapy was performed in all the cases with no maternal or foetal adverse events. The delivery was full term in all cases with an Apgar score of more than 8, except in 1 (10%) with an uneventful continuing pregnancy. It was concluded that endoscopic retrograde cholangiopancreatography, when indicated, is an effective and safe therapeutic procedure in pregnancy.