Management of inflammatory bowel disease in pregnancy

Ng, Susie W.; M, Uma

doi:10.1586/eci.12.103

Cited by 38 publications

(45 citation statements)

References 108 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For women with inactive IBD and without history of pelvic surgery, fertility is however comparable to their respective age-matched peers [18] . Pelvic surgery in IBD thus remains a major factor negatively impacting fertility, which varies with the extent and type of surgery [19] . Postsurgical adhesions also appear to play a key role in tubal infertility [20] .…”

Section: Fertilitymentioning

confidence: 99%

“…A meta-analysis evaluating IPAA in UC patients suggested that the risk of infertility increased 3-fold post-IPAA [23] . PCL [24] with IPAA has a more pronounced effect on fertility compared to the laparoscopic approach, which produces fewer adhesions [18,19,[23][24][25][26] . Studies involving laparoscopic IPAA indicate that women undergoing these procedures have significantly higher pregnancy rates as compared to open field IPAA [27] .…”

Section: Fertilitymentioning

confidence: 99%

“…While pregnancy has not been shown to specifically increase the risks of IBD "flares" [19] , approximately 30%-40% of women with IBD active at the time of conception will develop more intense disease or endure disease flares during pregnancy [33,34] . Some studies show that disease outcomes and flares in IBD outside of pregnancy are linked to environmental factors and lifestyle including hormone use, diet, mental health status, cigarette smoking, and vitamin D levels [35] .…”

Section: Disease Activity During Pregnancymentioning

confidence: 99%

“…Expectant mothers with IBD are at a greater risk for several complications including malnutrition, venous thromboembolism (VTE), antepartum hemorrhage, and cesarean delivery [19,47,48] . VTE is increased in women with UC, while antepartum hemorrhage risk is more prevalent in women with CD [47] .…”

Section: Pregnancymentioning

confidence: 99%

“…The risk of cesarean delivery is also increased in the setting of either UC or CD [48] . According to Ng et al [19] , women with perianal disease should opt for cesarean section, while those without perianal involvement can safely opt for a normal vaginal delivery.…”

Section: Pregnancymentioning

confidence: 99%

See 4 more Smart Citations

Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management

Hosseini‐Carroll¹,

Mutyala²,

Seth³

et al. 2015

WJGPT

View full text Add to dashboard Cite

Manas K made critical revisions of the manuscript; Becker F and Alexander JS contributed equally as senior authors. Conflict-of-interest statement:There are no known conflicts of interest. The authors (Pegah Hosseini-Carroll, Monica Mutyala, Abhishek Seth, Shaheen Nageeb, Demiana Soliman, Moheb Boktor, Ankur Sheth, Jonathon Chapman, James Morris, Paul Jordan, Kenneth Manas, Felix Becker, and J Steven Alexander) have no relevant financial considerations related to this proposal, and the study was not supported by any corporate entity. There is no known intellectual property associated with this report. AbstractInflammatory bowel diseases (IBD) are chronic idiopathic inflammatory conditions characterized by relapsing and remitting episodes of inflammation which can affect several different regions of the gastrointestinal tract, but also shows extra-intestinal manifestations. IBD is most frequently diagnosed during peak female reproductive years, with 25% of women with IBD conceiving after their diagnosis. While IBD therapy has improved dramatically with enhanced surveillance and more abundant and powerful treatment options, IBD disease can have important effects on pregnancy and presents several challenges for maintaining optimal outcomes for mothers with IBD and the developing fetus/neonate. Women with IBD, the medical team treating them (both gastroenterologists and obstetricians/gynecologists) must often make highly complicated choices regarding conception, pregnancy, and post-natal care (particularly breastfeeding) related to their choice of treatment options at different phases of pregnancy as well as post-partum. This current review discusses current concerns and recommendations for pregnancy during 157November 6, 2015|Volume 6|Issue 4| WJGPT|www.wjgnet.com Hosseini-Carroll P et al . Pregnancy and inflammatory bowel diseases IBD and is intended for gastroenterologists, general practitioners and IBD patients intending to become, (or already) pregnant, and their families. We have addressed patterns of IBD inheritance, effects of IBD on fertility and conception (in both men and women), the effects of IBD disease activity on maintenance of pregnancy and outcomes, risks of diagnostic procedures during pregnancy and potential risks and complications associated with different classes of IBD therapeutics. We also have evaluated the clinical experience using "top-down" care with biologics, which is currently the standard care at our institution. Post-partum care and breastfeeding recommendations are also addressed. Core tip: Inflammatory bowel diseases (IBD) are chronic inflammatory conditions characterized by relapsing and remitting episodes of intestinal inflammation. IBD is most frequently diagnosed during peak female reproductive years, with 25% of women with IBD conceiving after their diagnosis. While therapies have improved dramatically, IBDs have important effects on pregnancy and present challenges for maintaining optimal outcomes for mothers and their developing fetus/ neonate. Women with IBD and physician...

show abstract

Section: Fertilitymentioning

confidence: 99%