Every health decision holds a little more weight when you’re pregnant. Understandably so, since you’re making decisions for you and your baby. One question that can cause some serious anxiety is, “Can you get a colonoscopy while pregnant?” If you’re experiencing severe gastrointestinal symptoms or your doctor suspects a more serious issue, it’s essential to understand the benefits, risks, and alternatives of colonoscopies for pregnant women.
Keep reading to learn what they are.
Key Takeaways
- Colonoscopies are a last resort to diagnose gastrointestinal problems in pregnant women.
- If a colonoscopy must be performed, the second trimester is the safest time to do so.
- Potential risks involve preterm labor, fetal hypoxia, and miscarriage.
While you can technically get a colonoscopy while pregnant, it’s not the first (or second) option your doctor would recommend. They are generally reserved for cases where the benefits of having a colonoscopy outweigh the risks. It’s definitely not a procedure that a gastroenterologist would recommend lightly. This is mainly because of concerns about anesthesia exposure and the potential risks to both you and your baby. However, if your symptoms suggest a potentially serious condition, like inflammatory bowel disease (IBD), colorectal cancer, or severe gastrointestinal bleeding, your OB-GYN, along with your gastroenterologist, may agree to move forward with the procedure.
Timing Matters: When Is It Safest?
Studies show that when done extremely carefully, colonoscopies during pregnancy are relatively safe when performed in the second trimester. According to a 2014 study published in the World Journal of Gastroenterology, there’s no strong evidence linking colonoscopies to pregnancy complications when doctors take the appropriate precautions. However, the timing of the procedure is crucial. Waiting until the second trimester (between 13 and 26 weeks) is highly recommended. This is when the risk of miscarriage is lower and the uterus is still relatively small, all of which allows for safer sedation and less pressure to be put on the abdomen.
What Are the Risks?
Like any medical procedure during pregnancy, colonoscopies are not risk-free, which is why doctors are so hesitant to perform them. The biggest concerns include potential preterm labor, fetal hypoxia (a lack of oxygen to the baby), or even miscarriage, although this outcome is pretty rare. Practicing careful sedation and monitoring the baby before and after the procedure helps significantly reduce these risks, however. Having an experienced gastroenterologist work closely with your OB-GYN to ensure every possible precaution is taken is key to ensuring a successful outcome for you and your baby.
Special Considerations: What Adjustments Are Made?
Obviously, there are many differences in performing a colonoscopy on a pregnant patient as opposed to someone who’s not pregnant. As such, risk factors are taken into account, and special considerations and adjustments are made to ensure the procedure is as safe as possible and protect mom and baby:
- Sedation: Medications like propofol are generally avoided. Doctors will opt, instead, for lighter sedation or even conscious sedation to minimize the baby’s exposure to medication.
- Positioning: The patient is carefully positioned, typically on their left side, to prevent compression of the inferior vena cava. This is a large vein that can affect blood flow to the uterus if pressed on.
- Shorter Procedures: Colonoscopies usually last about an hour, not including recovery time. But with a pregnant patient, gastroenterologists would aim to make the procedure as quick and efficient as possible to reduce any potential stress on the pregnancy.
Guidelines for Endoscopy in Pregnant Women
Because of the serious risks involved, the American Society for Gastrointestinal Endoscopy created the following guidelines for endoscopists to follow when performing a colonoscopy on women who are pregnant:
- Always have a strong reason to perform the procedure, especially in high-risk pregnancies.
- Whenever possible, only perform the endoscopy during the second trimester.
- Use the lowest effective dose of sedation medication.
- Drugs used should be restricted to category B whenever possible.
- Reduce the procedure timeline to as short as possible.
- Avoid vena cava or aortic compression by positioning the patient in the left pelvic tilt or left lateral position.
- Check the baby’s heartbeat before sedation and after the procedure is complete.
- Obstetric support should be available whenever pregnancy-related complications occur. Keep obstetric support on standby in case pregnancy-related complications occur.
- Obstetric complications of endoscopy include placental abruption, imminent delivery, ruptured membranes, and eclampsia are defined.
What Are the Alternatives?
While colonoscopies continue to remain the gold standard when doctors need a clear, definitive look inside the colon, in some cases, like pregnancy, non-invasive alternatives may be considered first. For example, MRI enterography, CT colonography, and abdominal ultrasounds are three imaging studies that can sometimes provide enough information without requiring sedation or being as invasive as a colonoscopy.
Other alternatives include stool tests and bloodwork to detect blood in the stool and other information that could be enough to guide treatment decisions during pregnancy. It’s all about balancing the urgency of your GI symptoms with the safest diagnostic methods.
Trust RMC for Compassionate GI Care During Pregnancy
Like many aspects of a pregnancy journey, facing a colonoscopy while pregnant can feel overwhelming. However, you can rest assured that our experienced team of gastroenterologists and maternity medical care team will take every precaution to keep you and your baby safe. If you’re experiencing severe gastrointestinal symptoms or something just doesn’t feel right during your pregnancy, don’t wait—early evaluation can make a real difference in your health and peace of mind.
Contact RMC today to schedule an appointment or learn more about your options so you can receive the expert, compassionate care you and your baby deserve.