Management of Inflammatory Bowel Disease in Pregnancy: A Practical Approach to New Guidelines.

V Huang,C H Seow,Y Leung,G C Nguyen

doi:10.1155/2016/9513742

Abstract

Management of Inflammatory Bowel Disease in Pregnancy: A Practical Approach to New Guidelines.

Highlights

The medical literature has demonstrated that significant gaps in knowledge about the management of Inflammatory bowel disease (IBD) during pregnancy exist in both patients and their physicians, resulting in misperceptions about IBD therapies during pregnancy [2,3,4]; “voluntary childlessness” as a consequence of fear of infertility, the ability to cope with the pregnancy in the presence of disease, heritability of the disease, and adverse fetal outcomes [2,3,4]; medication nonadherence [3,4,5,6,7]; and misdirected physician-led modification or cessation of therapies in this cohort [7,8,9]
Acknowledging the knowledge gap and changing landscape of IBD management, “The Toronto Consensus Statements for the Management of Inflammatory Bowel Disease in Pregnancy” were developed, integrating upto-date evidence vetted by the GRADE approach and tailored to North American clinical practice [11]
Statement #3: In women with ulcerative colitis who are contemplating pregnancy and taking a 5-ASA formulation containing di-butyl phthalate (DBP), we suggest switching to a 5-ASA drug without DBP

Summary

Introduction

The medical literature has demonstrated that significant gaps in knowledge about the management of IBD during pregnancy exist in both patients and their physicians, resulting in misperceptions about IBD therapies during pregnancy [2,3,4]; “voluntary childlessness” as a consequence of fear of infertility, the ability to cope with the pregnancy in the presence of disease, heritability of the disease, and adverse fetal outcomes [2,3,4]; medication nonadherence [3,4,5,6,7]; and misdirected physician-led modification or cessation of therapies in this cohort [7,8,9]. Statement #5: In pregnant women with active or complicated IBD, we recommend consultation with an obstetrician, preferably one affiliated with a high-risk obstetrics program. Statement #8: In pregnant women with IBD on oral and/or rectal 5-ASA maintenance therapy, we recommend continuation of 5-ASA therapy throughout pregnancy.

Results

Conclusion