Risks and recomendations to perform flexible bronchoscopy in pregnant woman
Riesgos y recomendaciones para la realización de broncoscopia flexible en la paciente embarazada
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If possible, it is advisable to postpone Flexible Bronchoscopy until after delivery, or at least until after the twenty eighth week of pregnancy. Bronchoscopy should be carried out by the most experienced pulmonologist, and in a hospital facility where anesthesiology, obstetrics and neonatology departments are available. Consultation with these specialists is recommended. A pharmacologist should be consulted with regard to the teratogenic potential of the drugs that are to be used during bronchoscopy. The lowest possible doses of drugs should be used for sedation, and drugs of the D and X categories should not be used. During the procedure, it is advisable to carry out continual monitoring of cardiac rhythm and pulse oximetry, as well as intermittent measurements of arterial blood pressure. If possible, fetal monitoring should be carried out. The patient should be placed in the left lateral decubitus position. If this is not possible, the procedure should be carried out with the patient in the sitting position. The duration of the procedure should be minimized, and it should be terminated if the patient does not tolerate it well. The convenience of using fluoroscopy has to be considered separately in each case, taking into consideration its potential risks and benefits. Technological advances for the diagnosis and treatment of pulmonary and airway diseases, such as endobronchial ultrasound, CT scanning with fluoroscopy and bronchoscopy.
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