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妊娠期炎症性肠病:在东伦敦制定多学科护理路径

Inflammatory bowel disease in pregnancy: Developing a multidisciplinary care pathway in East London.

作者信息

Kaler Mandeep K, Malina Madeleine, Kok Klaartje, Khan Rehan

机构信息

Royal London Hospital, London, UK.

出版信息

Obstet Med. 2021 Dec;14(4):235-241. doi: 10.1177/1753495X211009747. Epub 2021 May 6.

DOI:10.1177/1753495X211009747
PMID:34880937
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8646220/
Abstract

OBJECTIVES

Evaluate the management of pregnant women with inflammatory bowel disease.

METHOD

We collected data from maternity records for women with IBD who gave birth at The Royal London Hospital between January 2018 and February 2019.

RESULTS

Twenty-three pregnancies were identified where 8/23 (35%) women had a peri-conception flare and 7/23 (30%) had a flare during pregnancy. Two women received pre-conception counselling. The obstetric medicine team reviewed a patient on average three times and the gastroenterologists twice, during pregnancy. Nine women (39%) gave birth pre-term. Mean birthweight was lower in the group with active disease at conception compared with those in remission (2173 g vs. 2807 g,  = 0.03).

CONCLUSIONS

Women with IBD should all receive pre-conception counselling to reduce the risk of pregnancy complications. By developing a multidisciplinary care pathway for pregnant women with IBD (which includes a joint obstetric/gastroenterology clinic), this will ensure care is standardised throughout the pregnancy and puerperium.

摘要

目的

评估炎症性肠病孕妇的管理情况。

方法

我们收集了2018年1月至2019年2月期间在皇家伦敦医院分娩的炎症性肠病女性的产科记录数据。

结果

共识别出23例妊娠,其中8/23(35%)的女性在受孕前后病情发作,7/23(30%)在孕期病情发作。两名女性接受了孕前咨询。产科医学团队在孕期平均对一名患者进行了三次检查,胃肠病学家进行了两次检查。9名女性(39%)早产。与病情缓解的女性相比,受孕时患有活动性疾病的女性组平均出生体重较低(2173克对2807克,P = 0.03)。

结论

炎症性肠病女性均应接受孕前咨询,以降低妊娠并发症的风险。通过为炎症性肠病孕妇制定多学科护理路径(包括联合产科/胃肠病学门诊),这将确保整个孕期和产褥期的护理标准化。

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本文引用的文献

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Standards for the provision of antenatal care for patients with inflammatory bowel disease: guidance endorsed by the British Society of Gastroenterology and the British Maternal and Fetal Medicine Society.炎症性肠病患者产前护理提供标准:英国胃肠病学会和英国母胎医学会认可的指南
Frontline Gastroenterol. 2020 May 7;12(3):182-187. doi: 10.1136/flgastro-2020-101459. eCollection 2021.
2
Inflammatory Bowel Disease in Pregnancy Clinical Care Pathway: A Report From the American Gastroenterological Association IBD Parenthood Project Working Group.妊娠期炎症性肠病临床护理路径:美国胃肠病学会IBD育儿项目工作组报告
Gastroenterology. 2019 Apr;156(5):1508-1524. doi: 10.1053/j.gastro.2018.12.022. Epub 2019 Jan 16.
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The Effects of Active IBD During Pregnancy in the Era of Novel IBD Therapies.新型炎症性肠病(IBD)治疗时代孕期活动性IBD的影响
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Inflammatory Bowel Disease Increases Risk of Adverse Pregnancy Outcomes: A Meta-Analysis.炎症性肠病增加不良妊娠结局风险:一项荟萃分析。
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The second European evidenced-based consensus on reproduction and pregnancy in inflammatory bowel disease.第二次欧洲炎症性肠病生殖与妊娠的循证共识。
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Birth outcomes in women with inflammatory bowel disease: effects of disease activity and drug exposure.炎症性肠病女性的生育结局:疾病活动度和药物暴露的影响。
Inflamm Bowel Dis. 2014 Jun;20(6):1091-8. doi: 10.1097/MIB.0000000000000060.
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J Perinatol. 2014 Jun;34(6):435-40. doi: 10.1038/jp.2014.41. Epub 2014 Mar 20.
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