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Chapter 42 - Crohn’s Disease in Pregnancy

from Section 7 - Hepato-Renal and Gastrointestinal Conditions in Pregnancy

Published online by Cambridge University Press:  23 February 2023

By
Waseem Ahmed ,
Amira El-Messidi  and
Robert Battat
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow
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Summary

A 26-year-old G2P1 with Crohn’s disease (CD) is referred by her primary care provider to your high-risk obstetrics unit for transfer of care at 10 weeks’ gestation by dating sonography. Routine prenatal investigations are unremarkable. She has no obstetric complaints.

Keywords

Inflammatory bowel disease, Crohn’s, pregnancyPharmacology, therapeutics, treatment, methotrexate, azathioprine, certolizumab, anti-tumor necrosis factor (anti-TNF) drugsPhysical examinationRadiology, endoscopy, magnetic resonance imaging (MRI), abdominal X-ray, sigmoidoscopyPerinatal risks, complications, maternal-fetal morbidity, adverse outcomeGenetic risksObstetric deliveryAntenatal disease flarePreconception counselingContraception
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 542 - 552
Publisher: Cambridge University Press
Print publication year: 2023

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References

Suggested Readings

ASGE Standard of Practice Committee, Shergill, AK, Ben-Menachem, T, et al. Guidelines for endoscopy in pregnant and lactating women. Gastrointest Endosc. 2012;76(1):18–24. [Correction in Gastrointest Endosc. 2013 May;77(5):833]CrossRefGoogle ScholarPubMed
Foulon, A, Dupas, JL, Sabbagh, C, et al. Defining the most appropriate delivery mode in women with inflammatory bowel disease: a systematic review. Inflamm Bowel Dis. 2017;23(5):712–720.Google Scholar
Mahadevan, U, McConnell, RA, Chambers, CD. Drug safety and risk of adverse outcomes for pregnant patients with inflammatory bowel disease. Gastroenterology. 2017 Feb;152(2):451–462.CrossRefGoogle ScholarPubMed
Mahadevan, U, Robinson, C, Bernasko, N, et al. Inflammatory bowel disease in pregnancy clinical care pathway: a report from the American Gastroenterological Association IBD Parenthood Project Working Group. Am J Obstet Gynecol. 2019;220(4):308–323.Google Scholar
Mahadevan, U, McConnell, RA, Chambers, CD. Drug safety and risk of adverse outcomes for pregnant patients with inflammatory bowel disease. Gastroenterology. 2017 Feb;152(2):451–462.CrossRefGoogle ScholarPubMed
Mahadevan, U, Wolf, DC, Dubinsky, M, et al. Placental transfer of anti-tumor necrosis factor agents in pregnant patients with inflammatory bowel disease. Clin Gastroenterol Hepatol. 2013 Mar;11(3):286–92; quiz e24.CrossRefGoogle ScholarPubMed
Nielsen, OH, Gubatan, JM, Juhl, CB, et al. Biologics for inflammatory bowel disease and their safety in pregnancy: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2020; S1542–3565(20):31281–31287.Google Scholar
Nguyen, GC, Seow, CH, Maxwell, C, et al. The Toronto consensus statements for the management of inflammatory bowel disease in pregnancy. Gastroenterology. 2016;150(3):734–757.CrossRefGoogle ScholarPubMed
Restellini, S, Biedermann, L, Hruz, P, et al. Update on the management of inflammatory bowel disease during pregnancy and breastfeeding. Digestion. 2020;101(Suppl 1):27–42.CrossRefGoogle ScholarPubMed
van der Woude, CJ, Ardizzone, S, Bengtson, MB, et al. The second European evidence-based consensus on reproduction and pregnancy in inflammatory bowel disease. J Crohns Colitis. 2015;9(2):107–124.CrossRefGoogle ScholarPubMed

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