The Impact of Inflammatory Bowel Disease on Pregnancy and the Fetus: A Literature Review

Abstract

Inflammatory bowel disease (IBD) is a constellation of devastating chronic inflammatory changes in the bowel, either involving the large or small bowel or part of both. As it is widely diagnosed in the fertile age group, this disorder can present itself, very commonly, during pregnancy and thus a better understanding of the disease can be an important factor to influence the maternal and fetal well-being. Medications are what is considered the first line in the management of this disease to control the symptoms or keep the disease in remission. In addition to this, the drugs used to keep the disease in remission can also cause significant adverse effects on the patient and the new nurturing life preparing itself for the outside world. What the fetus gets from the mother will stay for life with the child. We conducted an electronic literature review search which highlights the significance and impact of sustained remission of IBD and the cautious use of various drugs during pregnancy for that purpose. In addition to the influences already mentioned, It is evident that nutritional deficiencies can also prevail with the advancing disease, something to manage as a side note as well. These deficiencies can have a definite effect on the fetus and may cause developmental malformations. In order to avoid this process, a systemic and joint approach should be curtailed. This can reduce the adverse outcomes associated with this ailment during pregnancy.

İnflamatuar bağırsak hastalığı olan gebelerin klinik yönetimi ve sonuçları

“…The current study results showed that the activation of the disease might cause preterm birth. Pervez H et al have found IBD to be associated with preterm delivery (18). Morales et al studied the effects of CD on the course of pregnancy, and they reported that exacerbation of the disease was associated with an increased risk of premature labour.…”

“…Adhesiolysis was performed in one of those patients (due to rectal bleeding), and surgical resection (due to ileus) was conducted in the other patient. (13,18). Bar-Gil SA et al have found that delivery mode does not influence the natural history of IBD, and vaginal delivery is not associated with an increased risk of subsequent perianal disease in women with CD (10).…”

Enfermedad inflamatoria intestinal durante el embarazo

“…Dentro de ella se engloba la enfermedad de Crohn (EC) y la colitis ulcerativa (CU), dos espectros de la enfermedad que pueden tener presentaciones clínicas en común pero difieren en fisiopatología, localización, complicaciones y manejo. La EII puede presentarse en hombres y mujeres, con una mayor incidencia en personas en edad reproductiva, lo que condiciona a una posible presentación de la enfermedad durante el embarazo (1,2). La relación entre el embarazo y la enfermedad inflamatoria intestinal es compleja y aún se encuentra en estudio, ya que se sugiere que los cambios fisiológicos propios del embarazo, principalmente en el sistema inmunológico y la microbiota intestinal, podrían modificar el curso de la EII durante este periodo.…”

“…La relación entre el embarazo y la enfermedad inflamatoria intestinal es compleja y aún se encuentra en estudio, ya que se sugiere que los cambios fisiológicos propios del embarazo, principalmente en el sistema inmunológico y la microbiota intestinal, podrían modificar el curso de la EII durante este periodo. Por otro lado, cada vez hay más evidencia que indica que la enfermedad intestinal inflamatoria activa durante la gestación puede aumentar el riesgo de múltiples complicaciones en el embarazo y el parto (1). En esta revisión se hace hincapié en la evidencia que existe hasta el momento sobre la seguridad de los medicamentos más frecuentemente utilizados en la EII y de los fármacos que han surgido más recientemente como opción terapéutica para la enfermedad, como lo es la terapia biológica, específicamente durante el periodo gestacional, con el objetivo de brindar información actualizada de utilidad para los clínicos que se enfrenten al manejo de las EII en pacientes embarazadas que permita un tratamiento efectivo materno y represente, asimismo, el menor riesgo fetal posible.…”

Effects of Age and Sex on the Healing of Acetic-Acid Induced Ulcerative Colitis in Adult Wistar Rats

“…Colitis is the inflammation of the large intestine resulting in excruciating abdominal pain and discomfort in the body. Sometimes this abdominal pain may be mild or acute and persistent or re-occurring [1,2]. Ulcerative Colitis (UC) is often mistaken for Crohn's Disease (CD) though there are some differences between them.…”