Gastroparesis in pregnancy.

Sarvee Moosavi, Yang Won Min, Melissa Wong, Ali Rezaie

Journal: American journal of obstetrics and gynecology 2023;228(4):382-394

PMID: 36088986

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Abstract

Gastroparesis is a functional gastrointestinal disorder that more commonly affects women, with most cases being diagnosed during childbearing age. However, there is a paucity of data and guidelines to specifically highlight the epidemiology, disease course, maternal and fetal impact, and the management of existing gastroparesis during pregnancy. Apart from metoclopramide, there is no approved therapy specifically indicated for gastroparesis. More importantly, pregnant and breastfeeding women are excluded from clinical trials evaluating pharmacologic agents in the management of gastroparesis. This poses a real challenge to healthcare providers in counseling and managing patients with gastroparesis. In this systematic review, we summarize the current available literature and the knowledge gaps in the impact of pregnancy on gastroparesis and vice versa. We also highlight the efficacy and safety profiles of available pharmacologic and nonpharmacologic therapies in the management of patients with gastroparesis, with emphasis on judicious use of dietary approaches that are deemed relatively safe during pregnancy.

Address: Division of Gastroenterology, Department of Medicine, Vancouver General Hospital, The University of British Columbia, Vancouver, Canada. Electronic address: [email protected].; Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Medically Associated Science and Technology program, Cedars-Sinai Medical Center, Los Angeles, CA.; Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA.; Medically Associated Science and Technology program, Cedars-Sinai Medical Center, Los Angeles, CA; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA; GI Motility Program, Division of Gastroenterology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA.

DOI: 10.1016/j.ajog.2022.09.002

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MeSH Terms: Pregnancy, Humans, Female, Gastroparesis, Gastrointestinal Agents, Metoclopramide