title: Management of Inflammatory Bowel Disease During Pregnancy.
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.
authors.affiliation: IBD Center, Digestive Diseases Institute, Shaare Zedek Medical Center, Jerusalem, Israel. ariellash@szmc.org.il.
authors.forename: Ariella
authors.initials: A
authors.lastname: Bar-Gil Shitrit
authors.affiliation: Fetal Maternal Medicine, Obstetrics and Gynecology Department, Shaare Zedek Medical Center, Jerusalem, Israel.
authors.forename: Sorina
authors.initials: S
authors.lastname: Grisaru-Granovsky
authors.affiliation: IBD Center, Digestive Diseases Institute, Shaare Zedek Medical Center, Jerusalem, Israel.
authors.forename: Ami
authors.initials: A
authors.lastname: Ben Ya'acov
authors.affiliation: IBD Center, Digestive Diseases Institute, Shaare Zedek Medical Center, Jerusalem, Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Goldin
mesh_terms: D001942:Breast Feeding; D036861:Delivery, Obstetric; D018450:Disease Progression; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D009752:Nutritional Status; D016742:Preconception Care / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D016540:Smoking Cessation
chemical_list: D007166:Immunosuppressive Agents
keywords: Inflammatory bowel disease; Medications; Obstetric complications; Pregnancy; Remission