Inflammatory bowel disease
Koduri P. Inflammatory bowel disease. In: Berghella V, ed. Maternal-fetal evidence based guidelines. 4th ed. CRC Press; 2022.
Inflammatory bowel disease (IBD) primarily refers to Crohn's disease (CD) and ulcerative colitis (UC). CD and UC are chronic systemic inflammatory diseases that affect women of reproductive age. CD is a systemic inflammatory disease that mainly manifests as chronic, transmural, granulomatous inflammation of the gastrointestinal system. Women with active disease or with history of surgery related to IBD have an increased risk of infertility. Women with CD appear to be at increased risk for adverse pregnancy outcomes. Several population-based studies and two meta-analyses demonstrate an increased risk of preterm birth, cesarean delivery, and low birth-weight infants. Preconception counseling is associated with healthier lifestyle changes, improved medication compliance, and lower risk of relapse during pregnancy. Counseling should include input from a multidisciplinary team that includes a gastroenterologist, obstetrician, and maternal-fetal medicine provider. Treatment of CD is based on disease location, severity, and extraintestinal complications. Pharmacologic therapy is the mainstay of treatment.
Book Chapter/Book Details
In: Berghella V, ed. Maternal-fetal evidence based guidelines. 4th ed. CRC Press; 2022.