Management of Fertility and Pregnancy in Women with Inflammatory Bowel Disease: A Practical Guide

摘要

Women with inflammatory bowel disease (IBD) are often young and of childbearing age. When a woman with IBD considers pregnancy or inadvertently finds herself pregnant, the management of her pregnancy should be a multidisciplinary team effort. Members of the team often include obstetricians who specialize in high-risk pregnancy, gastroenterologists, and colorectal surgeons. Patients with IBD may have decreased fertility and require the expertise of assisted reproduction specialists. Many different factors, including disease activity, type and extent of IBD, history of abdominal surgery, and medications, may affect conception and pregnancy outcomes. Because IBD encompasses a variety of disease locations and behaviors, a detailed individualized treatment approach is needed. Gastroenterologists should be even more meticulous and aggressive than usual in caring for pregnant patients as disease activity and medication cessation are probably the 2 most important factors causing adverse pregnancy outcomes.