Mo1252 The Impact of Mode of Delivery on Long-Term Outcomes in Patients With Perianal Crohn's Disease

Cheng, Alice G; Oxford, Emily C; Nguyen, Deanna D.; Sauk, Jenny; Yajnik, Vijay; Friedman, Sonia; Ananthakrishnan, Ashwin N.

doi:10.1016/s0016-5085(14)62167-3

Cited by 9 publications

(14 citation statements)

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“…33 Two recent studies found no increased risk in symptomatic perianal flares in women with perianal Crohn disease who delivered vaginally or by cesarean. 34,35 Mode of delivery also did not influence the natural history of inflammatory bowel disease. However, women with active perianal disease at the time of delivery should have a cesarean delivery to avoid trauma that may exacerbate the disease.…”

Section: [Abstract]mentioning

confidence: 88%

Care of the Pregnant Patient With Inflammatory Bowel Disease

Matro

2015

Obstetrics &Amp; Gynecology

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Inflammatory bowel disease affects women in their peak reproductive years. Patients and physicians often have questions regarding the effect of inflammatory bowel disease on a woman's ability to conceive and to carry a pregnancy safely to term as well as the effect of inflammatory bowel disease and the medications used to treat it on pregnancy outcomes. Women with inflammatory bowel disease have the same rates of fertility as women without inflammatory bowel disease unless they have had prior surgery in the pelvis or active disease. However, women with inflammatory bowel disease do have higher rates of adverse pregnancy outcomes. A multidisciplinary approach involving gastroenterologists, obstetricians, and maternal-fetal medicine physicians should focus on preconception planning and disease optimization before pregnancy. Women with inflammatory bowel disease should be followed as high-risk obstetric patients. Most medications used to treat inflammatory bowel disease can be continued safely during pregnancy and lactation. The greatest risk to the pregnancy is active disease, which can be precipitated by discontinuation of effective maintenance medications. Preconception counseling should include education regarding the low risk of most inflammatory bowel disease medications during pregnancy and lactation and the high risk of a significant disease flare during pregnancy. This review outlines important considerations for obstetricians caring for women with inflammatory bowel disease before and during pregnancy and in the postpartum period.

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Section: [Abstract]mentioning

confidence: 88%

Care of the Pregnant Patient With Inflammatory Bowel Disease

Matro

2015

Obstetrics &Amp; Gynecology

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“…44 Some cohort studies have reported no difference in the rates of symptomatic perianal or luminal disease flares after delivery based on whether cesarean or vaginal delivery was performed. [180][181][182] Other studies have reported development of new perianal disease 183 or worsening in women with active perianal disease 179 after vaginal delivery. However, several case series have suggested that cesarean delivery is not protective against flare in women with a history of perianal disease.…”

Section: Medical Management Of Ibd During Pregnancymentioning

confidence: 99%

The Toronto Consensus Statements for the Management of Inflammatory Bowel Disease in Pregnancy

et al. 2016

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“…The use of this data repository in has been described in previous publications from our centre. [24][25][26][27] For this study, we adopted a casecontrol design. We first identified all potential IBD patients with at least one ICD-9-CM code for CD (555.x) or UC (556.x).…”

Section: Study Population -Cases and Controlsmentioning

confidence: 99%