生殖期炎症性肠病的治疗:最新叙述综述

IF 1.1 Q4 OBSTETRICS & GYNECOLOGY Reproductive medicine (Basel, Switzerland) Pub Date : 2023-08-03 DOI:10.3390/reprodmed4030017
Nariman Hossein-javaheri, Michael Youssef, Y. Jeyakumar, V. Huang, P. Tandon
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引用次数: 0

摘要

炎症性肠病(IBD)经常影响育龄妇女,通常与怀孕同时发生。随着IBD发病率的增加,胃肠病学家和产科医生更频繁地参与照顾育龄妇女。虽然新疗法的发展已经允许成功受孕和妊娠结局,但由于担心IBD对母婴健康的不利影响,许多患者可能会犹豫怀孕。因此,相当一部分患者可能会选择自愿不生育。事实上,活动性IBD具有更大的不良妊娠结局风险,包括流产、早产和紧急剖腹产。然而,那些患有静止性疾病的人往往很少有妊娠并发症。因此,必须在受孕前达到缓解,以优化妊娠结局。专门的IBD和妊娠诊所可以极大地帮助提高患者对妊娠的认识和态度;通过个体化孕前咨询、教育和药物依从性,可以将不良妊娠结局的风险降至最低。此外,对于医疗保健提供者来说,在妊娠期和哺乳期为患者提供咨询时,充分了解药物安全性和测量疾病活动的工具是很重要的。这篇综述文章旨在为妊娠期IBD提供最新的循证管理方法。
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The Management of Inflammatory Bowel Disease during Reproductive Years: An Updated Narrative Review
Inflammatory bowel disease (IBD) frequently affects women of childbearing age and often coincides with pregnancy. With an increased incidence of IBD, gastroenterologists and obstetricians are more frequently involved in caring for women of reproductive age. While the development of novel therapies has allowed for successful conception and pregnancy outcomes, many patients may hesitate to conceive due to concerns for presumed adverse IBD effects on maternal and fetal health. As such, a noticeable percentage of patients may choose voluntary childlessness. Indeed, active IBD carries a greater risk of adverse pregnancy outcomes, including a loss of pregnancy, preterm delivery, and emergent C-sections. However, those with a quiescent disease tend to have fewer pregnancy complications. Therefore, it is essential to achieve remission prior to conception to optimize pregnancy outcomes. Dedicated IBD and pregnancy clinics can greatly assist in improving patient knowledge and attitudes towards pregnancy; through individualized pre-conception counseling, education, and medication adherence, the risks of poor pregnancy outcomes can be minimized. Furthermore, it is important for healthcare providers to have a sufficient understanding of the medication safety and tools to measure the disease activity, while counseling patients during gestation and breastfeeding periods. This review article aims to provide the most recent evidence-based management methods for IBD during pregnancy.
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