Document Detail

Management of inflammatory bowel disease in pregnancy.
MedLine Citation:
PMID:  22595185     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIMS: Inflammatory bowel disease (IBD) is a chronic disease affecting mainly young people in their reproductive years. IBD therefore has a major impact on patients' family planning decisions. Management of IBD in pregnancy requires a challenging balance between optimal disease control and drug safety considerations. This article aims to provide a framework for clinical decision making in IBD based on review of the literature on pregnancy-related topics.
METHODS: Medline searches with search terms 'IBD', 'Crohn's disease' or 'ulcerative colitis' in combination with keywords for the topics fertility, pregnancy, congenital abnormalities and drugs names of drugs used for treatment of IBD.
RESULTS: IBD patients have normal fertility, except for women after ileal pouch-anal anastomosis (IPAA) and men under sulfasalazine treatment. Achieving and maintaining disease remission is a key factor for successful pregnancy outcomes in this population, as active disease at conception carries an increased risk of preterm delivery and low birth weight. Clinicians should discuss the need for drug therapy to maintain remission with their patients in order to ensure therapy compliance. Most IBD drugs are compatible with pregnancy, except for methotrexate and thalidomide. If possible, anti-TNF therapy should be stopped by the end of the second trimester and the choice of delivery route should be discussed with the patient.
CONCLUSIONS: Disease control prior to conception and throughout pregnancy is the cornerstone of successful pregnancy management in IBD patients.
Séverine Vermeire; Franck Carbonnel; Pierre G Coulie; Vincent Geenen; Johanna M W Hazes; Pierre L Masson; Filip De Keyser; Edouard Louis
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2012-05-16
Journal Detail:
Title:  Journal of Crohn's & colitis     Volume:  6     ISSN:  1876-4479     ISO Abbreviation:  J Crohns Colitis     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-07     Completed Date:  2012-12-18     Revised Date:  2013-12-31    
Medline Journal Info:
Nlm Unique ID:  101318676     Medline TA:  J Crohns Colitis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  811-23     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.
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MeSH Terms
Colitis, Ulcerative / complications,  drug therapy,  therapy
Crohn Disease / complications,  drug therapy,  therapy
Fertility / drug effects
Immunosuppressive Agents / therapeutic use
Inflammatory Bowel Diseases / complications*,  drug therapy,  therapy
Lactation / drug effects
Pregnancy Complications / drug therapy,  therapy*
Pregnancy Outcome
Reg. No./Substance:
0/Immunosuppressive Agents
Comment In:
J Crohns Colitis. 2013 Dec 15;7(12):e716   [PMID:  24055456 ]

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