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Digestive Diseases and Sciences
Published in: Digestive Diseases and Sciences 8/2016

01-08-2016 | Review

Management of Inflammatory Bowel Disease During Pregnancy

Authors: Ariella Bar-Gil Shitrit, Sorina Grisaru-Granovsky, Ami Ben Ya’acov, Eran Goldin

Published in: Digestive Diseases and Sciences | Issue 8/2016

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Abstract

Inflammatory bowel disease (IBD) usually affects women during their reproductive years and many concerns arise among these young patients. Pre-pregnancy consultation with a multi-disciplinary team is very important. The team should make patients aware of the critical importance of ensuring that conception occurs during a period of disease remission. Conception during an IBD flare-up results in disease activity or even exacerbates disease in two-thirds of women. Exacerbation of the disease is associated with increased frequency of maternal and fetal complications. Drug therapy constitutes a considerable source of patient anxiety but most drugs used for treating IBD are considered safe. Therefore, continuing pharmacological therapy during pregnancy is necessary to maintain disease control. Optimization of pre-conception nutritional status and smoking cessation are also emphasized. The general guideline for most patients, except for active perianal disease patients, is to aim for vaginal delivery in the absence of obstetric contraindications. Consistent, ongoing follow-up, as detailed in this review, should allay the anxieties and fears surrounding continuing immunosuppressive drugs during pregnancy, allowing each patient to attain the optimal conditions for achieving her goal of holding a healthy baby.
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A SPECIAL MEETING REVIEW EDITION: Highlights in Crohn’s Disease and Ulcerative Colitis: Digestive Disease Week 2012 May 19-22, 2012 * San Diego, CaliforniaSpecial Reporting on:* Safety and Efficacy of Subcutaneous Golimumab Induction Therapy in Patients with Moderately to Severely Active UC: PURSUIT-SC* The Future of IBD Therapy: Individualized and Optimized Therapy and Novel Mechanisms* Infliximab Concentration and Clinical Outcome in Patients with UC* Vedolizumab Induction Therapy for UC: Results of GEMINI I, A Randomized, Placebo-Controlled, Double-Blind, Multicenter, Phase III Trial* Novel Infliximab and Antibody-to-lnfliximab Assays Are Predictive of Disease Activity in Patients with CD* Accelerated Step-Care Therapy with Early Azathioprine Versus Conventional Step-Care Therapy in CD* PIANO: A 1,000-Patient Prospective Registry of Pregnancy Outcomes in Women with IBD Exposed to Immunomodulators and Biologic TherapyPLUS Meeting Abstract Summaries With Expert Commentary by: William J. Sandborn, MDChief of the Division of Gastroenterology Director of the UCSD IBD Center UC San Diego Health System La Jolla, California. Gastroenterol Hepatol (N Y). 2012;8:1–24.
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Metadata
Title
Management of Inflammatory Bowel Disease During Pregnancy
Authors
Ariella Bar-Gil Shitrit
Sorina Grisaru-Granovsky
Ami Ben Ya’acov
Eran Goldin
Publication date
01-08-2016
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 8/2016
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-016-4139-9

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