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The U.S. Food and Drug Administration categorizes drugs into five groups based on the evidence of their safety during pregnancy. (FDA Drug Safety Categories). However, these categories are of limited value for determining the safety of one-time use. Therefore, consultation with an obstetrician and/or an anesthesiologist regarding medication use during pregnancy should be considered. There are no category A drugs used for endoscopy sedation. In general, category B and when necessary, category C drugs are recommended. For procedural sedation during pregnancy, meperidine alone is preferred, (category B). If required, meperidine can be followed by small doses of midazolam (category D). In cases where a benzodiazepine is used, midazolam should be chosen over diazepam. However, midazolam should be avoided if possible during the first trimester

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