Skip to main content
Journal cover image

Endoscopic management and outcomes of pregnant women hospitalized for nonvariceal upper GI bleeding: a nationwide analysis.

Publication ,  Journal Article
Nguyen, GC; Dinani, AM; Pivovarov, K
Published in: Gastrointest Endosc
November 2010

BACKGROUND: Upper GI endoscopy has an important diagnostic and therapeutic role in the management of nonvariceal upper GI bleeding (NVUGB). OBJECTIVE: To characterize nationwide patterns of utilization of upper GI endoscopy in pregnant women with NVUGB and to assess health outcomes. DESIGN: Retrospective cohort study. SETTING: Participating hospitals from the Nationwide Inpatient Sample, 1998-2007. PATIENTS: Pregnant and age-matched nonpregnant women admitted for NVUGB. INTERVENTION: The study population was classified as pregnant women with NVUGB (n = 1210) and nonpregnant women with NVUGB (n = 6050). MAIN OUTCOME MEASUREMENTS: Rate of upper GI endoscopy, maternal mortality, fetal death/complications, and premature delivery. RESULTS: Pregnant women were less likely than nonpregnant women to undergo upper GI endoscopy (26% vs 69%; P < .0001) even after adjustment for comorbidities, transfusion requirement, and the presence of hypovolemic shock (adjusted odds ratio, 0.19; 95% confidence interval, 0.16-0.22). Among those who underwent endoscopy, pregnant women were less likely to undergo the procedure within 24 hours of admission (50% vs 57%; P = .02). Mortality was lower among pregnant women compared with nonpregnant women (0% vs 0.6%; P = .006). In comparing outcomes between those who did and did not undergo endoscopy, there was no difference in fetal loss (0.2% vs 0.6%), fetal distress/complications (2.7% vs 2.6%), or premature delivery (7.3% vs 6.4%). LIMITATIONS: The study was based on administrative data. CONCLUSION: A conservative nonendoscopic approach is common in the management of pregnant women with NVUGB and is not associated with worse maternal or fetal outcomes. Upper GI endoscopy is, however, safe when judiciously implemented in the actively bleeding patient.

Duke Scholars

Published In

Gastrointest Endosc

DOI

EISSN

1097-6779

Publication Date

November 2010

Volume

72

Issue

5

Start / End Page

954 / 959

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • Treatment Outcome
  • Retrospective Studies
  • Pregnancy Complications
  • Pregnancy
  • Middle Aged
  • Humans
  • Hospitalization
  • Gastrointestinal Hemorrhage
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Nguyen, G. C., Dinani, A. M., & Pivovarov, K. (2010). Endoscopic management and outcomes of pregnant women hospitalized for nonvariceal upper GI bleeding: a nationwide analysis. Gastrointest Endosc, 72(5), 954–959. https://doi.org/10.1016/j.gie.2010.07.018
Nguyen, Geoffrey C., Amreen M. Dinani, and Kevin Pivovarov. “Endoscopic management and outcomes of pregnant women hospitalized for nonvariceal upper GI bleeding: a nationwide analysis.Gastrointest Endosc 72, no. 5 (November 2010): 954–59. https://doi.org/10.1016/j.gie.2010.07.018.
Nguyen, Geoffrey C., et al. “Endoscopic management and outcomes of pregnant women hospitalized for nonvariceal upper GI bleeding: a nationwide analysis.Gastrointest Endosc, vol. 72, no. 5, Nov. 2010, pp. 954–59. Pubmed, doi:10.1016/j.gie.2010.07.018.
Nguyen GC, Dinani AM, Pivovarov K. Endoscopic management and outcomes of pregnant women hospitalized for nonvariceal upper GI bleeding: a nationwide analysis. Gastrointest Endosc. 2010 Nov;72(5):954–959.
Journal cover image

Published In

Gastrointest Endosc

DOI

EISSN

1097-6779

Publication Date

November 2010

Volume

72

Issue

5

Start / End Page

954 / 959

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • Treatment Outcome
  • Retrospective Studies
  • Pregnancy Complications
  • Pregnancy
  • Middle Aged
  • Humans
  • Hospitalization
  • Gastrointestinal Hemorrhage