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Maternal bowel disease 

Maternal bowel disease
Chapter:
Maternal bowel disease
Author(s):

Harini Narayan

DOI:
10.1093/med/9780199673643.003.0015
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date: 29 May 2020

Ulcerative colitis and Crohn’s disease both tend to present in young adulthood. While most women with inflammatory bowel disease (IBD) will have uneventful pregnancies, disease activity at the time of conception strongly influences its course during gestation as well as pregnancy outcomes. This chapter deals with aetiology, epidemiology, pathophysiology, and the expected course during pregnancy. The association of active IBD with pregnancy complications, such as miscarriages, nutritional malabsorption, IUGR, and preterm births is explored. Pre-conceptual advice includes the need for folic acid and other supplements and smoking cessation, continuation of those drugs with a good safety profile in pregnancy and lactation. Those that are contraindicated in pregnancy are discussed. Pregnancy management with gastroenterology input, proactive management of a relapse, fetal growth scans and avoidance of unnecessary interventions are highlighted. Care pathways present clear integrated management plans from pre-pregnancy to the puerperium including breastfeeding. Patient information is provided.

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