Inflammatory Bowel Disease in Pregnancy

Aka: Inflammatory Bowel Disease in Pregnancy, Crohn's Disease in Pregnancy, Ulcerative Colitis in Pregnancy

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II. Risks for Pregnancy

  1. Non-active Inflammatory Bowel does not affect pregnancy
  2. Risks of uncontrolled active Inflammatory Bowel Disease
    1. Miscarriage
    2. Premature labor and preterm delivery
    3. Intrauterine Growth Retardation

III. Evaluation

  1. Avoid endoscopy in pregnancy due to Preterm Labor risk
  2. Avoid radiographic imaging in pregnancy

IV. Management

  1. Recommended in Active Inflammatory Bowel
    1. Sulfasalazine
      1. Potential risk of Kernicterus in newborns
      2. Avoid near term if possible
    2. Corticosteroids
    3. Mesalamine (5-ASA)
  2. Agents to use with caution in refractory disease
    1. Azathioprine
    2. Mercaptopurine
  3. Agents to avoid in pregnancy
    1. Immunosuppressants
    2. Methotrexate

V. References

  1. Larimore (2000) Prim Care 27(1):35-53 [PubMed]
  2. Botoman (1998) Am Fam Physician 57(1):57-72 [PubMed]

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