Zeldis J B
West J Med. 1989 Aug;151(2):168-71.
Conclusions about the relationship between the pathophysiology and treatment of inflammatory bowel disease and the physiology and management of pregnancy are based on the results of several large physician surveys and retrospective chart reviews. Patients with active disease fare worse than those with inactive disease. There is little evidence that pregnancy affects the course of inflammatory bowel disease or that inactive inflammatory bowel disease affects the course of pregnancy. Judicious medical therapy is effective in controlling inflammatory bowel disease during pregnancy. Sulfasalazine or steroid therapy should not be withdrawn in a patient who needs it to achieve or maintain a quiescent state of inflammatory bowel disease during the course of pregnancy. Immunosuppressive therapy should be avoided. Aggressive medical therapy with total parenteral nutrition in a team approach with a gastroenterologist, surgeon, and perinatologist usually avoids the need for surgical intervention during pregnancy with a good fetal outcome in a patient whose disease is active. Contraception against pregnancy need only be considered in those patients whose disease is so severe that operative therapy is imminent.
关于炎症性肠病的病理生理学与治疗和妊娠的生理学与管理之间关系的结论，是基于几项大型医生调查结果和回顾性病历审查得出的。患有活动性疾病的患者情况比非活动性疾病患者更差。几乎没有证据表明妊娠会影响炎症性肠病的病程，也没有证据表明非活动性炎症性肠病会影响妊娠过程。明智的药物治疗在控制妊娠期炎症性肠病方面是有效的。对于在妊娠期间需要使用柳氮磺胺吡啶或类固醇疗法来达到或维持炎症性肠病静止状态的患者，不应停用这些药物。应避免使用免疫抑制疗法。对于患有活动性疾病的患者，通过与胃肠病学家、外科医生和围产医学专家团队合作，采用全胃肠外营养进行积极的药物治疗，通常可避免在妊娠期间进行手术干预，并取得良好的胎儿结局。仅在那些疾病非常严重以至于即将进行手术治疗的患者中才需要考虑避孕。
