Preconception, antenatal and postpartum management of inflammatory bowel disease.

Aust J Gen Pract

MBBS, FRACP, MD, Consultant Gastroenterologist, Monash Health, Melbourne, Vic.

Published: October 2022

AI Article Synopsis

  • Inflammatory bowel disease (IBD) can be a worry for women during pregnancy because it can cause sickness for 20% to 55% of them.
  • This review wants to give helpful info about how to handle IBD before and during pregnancy, especially for doctors.
  • Close checking of the woman's health is important, and most IBD medicines are safe during pregnancy, but doctors should act quickly if the patient gets really sick.

Article Abstract

Background: Inflammatory bowel disease (IBD), comprising ulcerative colitis and Crohn's disease, commonly affects individuals of childbearing age. Pregnancy in women with IBD presents an anxiety-provoking prospect for practitioners and patients alike, with disease flares occurring in between 20% and 55% of patients antenatally.

Objective: The aim of this review is to provide an overview of antenatal IBD management principles and therapeutic goals, with a specific focus on the role of general practitioners.

Discussion: A collaborative approach is favoured in managing pregnancy and IBD. Preconception counselling should be prioritised, with emphasis on the importance of achieving three months of preconception corticosteroid-free remission. Close monitoring of disease activity in pregnancy is crucial, warranting the careful interpretation of both clinical and biochemical parameters. Reassurance regarding the safety of IBD medications in pregnancy and vaginal delivery can be provided in the majority of cases. Specialist support should be sought expeditiously in the setting of disease flare, particularly where symptoms and biochemical parameters are refractory to escalation of 5-aminosalicylates or topical therapies, corticosteroids or biologic agents are required, or an emergent IBD complication is suspected.

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Source
http://dx.doi.org/10.31128/AJGP-04-22-6400DOI Listing

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