Korelitz B I
Department of Medicine, Lenox Hill Hospital, New York, New York, USA.
Gastroenterol Clin North Am. 1998 Mar;27(1):213-24. doi: 10.1016/s0889-8553(05)70354-x.
Despite the lack of prospective studies on the relationship between inflammatory bowel disease (IBD) and pregnancy, the evidence strongly supports the conclusions that fertility is compromised in active Crohn's disease; heredity plays an important role in type and location of disease; fetal outcome is essentially no different than in the general population, except in the presence of active Crohn's disease during pregnancy; and the course of IBD during pregnancy is influenced by disease activity or lack of it before pregnancy. The major influence on outcome of pregnancy, fetal outcome, and course of IBD is the favorable effect of drug therapy on the disease. Most drugs, including sulfasalazine, 5ASA products, corticosteroids, and immunosuppressives, are safe, certainly safer than permitting the disease to be active and allowing for the possibility of surgical intervention during pregnancy. Episiotomy is contraindicated in women with Crohn's disease and perirectal complications. Cesarean section probably is indicated in most patients with Crohn's disease with colonic involvement.
尽管缺乏关于炎症性肠病（IBD）与妊娠关系的前瞻性研究，但现有证据有力地支持以下结论：活动性克罗恩病患者的生育能力会受到损害；遗传因素在疾病的类型和部位方面起着重要作用；除孕期患有活动性克罗恩病外，胎儿结局与普通人群基本无异；孕期IBD的病程受孕前疾病活动与否的影响。药物治疗对疾病的有利作用是对妊娠结局、胎儿结局和IBD病程的主要影响因素。大多数药物，包括柳氮磺胺吡啶、5-氨基水杨酸制剂、皮质类固醇和免疫抑制剂，都是安全的，肯定比任由疾病处于活动状态以及在孕期进行手术干预更安全。患有克罗恩病及直肠周围并发症的女性禁忌行会阴切开术。大多数患有累及结肠的克罗恩病患者可能需要行剖宫产术。
