Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management
Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management作者机构：Department of Medicine Section of Gastroenterology and Hepatology Louisiana State University Health Sciences Center Department of Molecular and Cellular Physiology Louisiana State University Health Sciences Center Digestive Health Center of Louisiana Department of General and Visceral Surgery
出 版 物：《World Journal of Gastrointestinal Pharmacology and Therapeutics》 (世界胃肠药理与治疗学杂志（英文版）（电子版）)
年 卷 期：2015年第6卷第4期
页 面：156-171页
学科分类：1002[医学-临床医学] 100211[医学-妇产科学] 10[医学]
主 题：Inflammatory bowel diseases Pregnancy Biologics Br
摘 要：Inflammatory 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 duringIBD 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.
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