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[炎症性肠病与妊娠:从受孕到分娩]

[IBD and pregnancy: From conception to birth].

作者信息

Foulon A, Chevreau J, Yzet C, Gondry J, Fumery M

机构信息

Centre de gynécologie-obstétrique, CHU Amiens-Picardie, 1, rue du Professeur-Christian-Cabrol, 80054 Amiens, France.

Centre de gynécologie-obstétrique, CHU Amiens-Picardie, 1, rue du Professeur-Christian-Cabrol, 80054 Amiens, France.

出版信息

Gynecol Obstet Fertil Senol. 2020 Jun;48(6):514-519. doi: 10.1016/j.gofs.2020.02.013. Epub 2020 Mar 4.

Abstract

Inflammatory Bowel Diseases (IBD) are chronic conditions affecting young people in their reproductive age. Patient misinformation can be responsible for a self-imposed infertility as well as a suboptimal observance during pregnancy. The aim of this work was to review the influence of IBD and pregnancy on one another at each gestational stage and according to current literature. IBD activity is a major influential factor. In case of a well-controlled IBD, fertility won't be affected and pregnancy will take place without increase risk of complications. With the exception of thalidomide and methotrexate, most of treatments used in IBD are compatible with pregnancy and breastfeeding. Each flare should be optimally managed. Vaginal delivery is a safe option except for patients with active anoperineal lesions. Cesarean section should be systematically discuss in patient with ileal pouch-anal anastomosis.

摘要

炎症性肠病(IBD)是影响育龄年轻人的慢性疾病。患者的错误信息可能导致自我施加的不孕以及孕期的不规范依从。这项工作的目的是根据当前文献,回顾IBD与妊娠在每个妊娠阶段对彼此的影响。IBD活动是一个主要影响因素。在IBD得到良好控制的情况下,生育能力不会受到影响,妊娠将在不增加并发症风险的情况下发生。除沙利度胺和甲氨蝶呤外,IBD中使用的大多数治疗方法都与妊娠和母乳喂养兼容。每次发作都应得到最佳管理。除有活动性肛门会阴病变的患者外,阴道分娩是一种安全的选择。对于行回肠储袋肛管吻合术的患者,应系统地讨论剖宫产问题。

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