Inflammatory Bowel Disease in Pregnancy

Abstract

Inflammatory bowel disease (IBD) affects women in their reproductive years with severe disease associated with maternal morbidity and adverse fetal outcome. A retrospective chart review was conducted for all patients admitted under the departments of Medicine and Obstetrics from 2012 to 2018. The patients with IBD in pregnancy were identified. The inpatient and outpatient charts of these patients were reviewed for the clinical profile, treatment received, and outcomes. We report our experience of managing pregnant women with IBD in South India. Of the five patients, two presented with the active severe disease during pregnancy and were treated with steroids and azathioprine of whom, one developed chorioamnionitis and the other metabolic complications. All except one pregnancy required operative delivery. Pregnancy outcomes in IBD are dependent on the disease activity status at conception. Diagnosis of IBD in pregnancy is a challenge, as full-length colonoscopy and computed tomography imaging is not feasible. Chorioamnionitis is a complication associated with IBD, probably due to immunosuppressive drugs.