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Inflammatory bowel disease pregnancy

Uma Mahadevan, Ryan A McConnell, Christina Chambers
The management of the pregnant patient with inflammatory bowel disease (IBD) is complicated by multiple providers, misinformation and a disease entity that, particularly when active, can adversely affect pregnancy outcomes. This paper seeks to frame the debate on medication safety in pregnancy and lactation using the Food and Drug Administration's new Pregnancy and Lactation Labeling Rule (PLLR) and the most up to date safety information to discuss the risks and benefits of using each class of IBD medication...
October 18, 2016: Gastroenterology
Christian Mottet, Alain M Schoepfer, Pascal Juillerat, Jacques Cosnes, Florian Froehlich, Vera Kessler-Brondolo, Frank Seibold, Gerhard Rogler, Stephan R Vavricka, Pierre Michetti
The relevance of azathioprine and 6-mercaptopurine therapy in inflammatory bowel disease, Crohn's disease, and ulcerative colitis, has been challenged in recent publications. In this article, a panel of experts gives advice, based on the relevant literature, on indications and practical use of azathioprine/6-mercaptopurine, prevention, and management of drug adverse reactions and special situations such as vaccination, pregnancy, and lactation.
November 2016: Inflammatory Bowel Diseases
Emire Seyahi
PURPOSE OF REVIEW: Takayasu arteritis has long been considered as an uncommon disease, rather specific to the Far-East; however recent surveys show that the disease can be seen in all ethnicities around the world with increasing prevalence rates. Nowadays, it would not be fair to consider Takayasu arteritis as a rare disease. RECENT FINDINGS: Although involvement of the thoracic aorta and its branches was more common among females, males had a tendency toward limited involvement of the abdominal aorta and its branches...
September 29, 2016: Current Opinion in Rheumatology
Gabriella Bröms, Fredrik Granath, Olof Stephansson, Helle Kieler
BACKGROUND: The inflammatory bowel diseases (IBD), Crohn's disease (CD) and ulcerative colitis (UC) have been associated with an increased risk of preterm birth. MATERIAL AND METHODS: We identified all 246 singleton preterm births among women with IBD between July 2006 and December 2010 as cases and an equal number of controls with IBD from the Swedish national health registers, matched by maternal age, parity and IBD diagnosis (CD/UC). From register data and medical charts, we obtained information on reproductive history, comorbidity, disease activity and drug treatment (corticosteroids, 5-aminosalicylates, sulfasalazine, thiopurines and anti-TNF) as risk factors for preterm birth...
December 2016: Scandinavian Journal of Gastroenterology
Ellen P Carlin, Nichole Giller, Rebecca Katz
OBJECTIVE: To quantify the population at risk of serious adverse reactions to replicating smallpox vaccine. DESIGN AND SAMPLE: Conditions known or suspected to carry risk were identified via Centers for Disease Control and Prevention planning documents, other federal publications, and peer-reviewed literature. Conditions identified were categorized as historically recognized risks or more recently recognized immunocompromised states that may pose risk. Major historical risk factors were as follows: eczema/atopic dermatitis, pregnancy, HIV, and primary immunodeficiency...
October 13, 2016: Public Health Nursing
Vivian Wai-Mei Huang, Hsiu-Ju Chang, Karen Ivy Kroeker, Karen Jean Goodman, Kathleen M Hegadoren, Levinus Albert Dieleman, Richard Neil Fedorak
Background. Inflammatory bowel disease (IBD) affects patients in their young reproductive years. Women with IBD require maintenance therapies during pregnancy and breastfeeding. However, physician management of IBD during pregnancy and breastfeeding has not been well characterized. Objective. To characterize physician perceptions and management of IBD during pregnancy and breastfeeding. Methods. A cross-sectional survey of Canadian physicians who are involved in the care of women with IBD was conducted. The survey included multiple-choice and Likert scale questions about perceptions and practice patterns regarding the management of IBD during pregnancy and breastfeeding...
2016: Canadian Journal of Gastroenterology & Hepatology
Isabel Carbery, Jihane Ghorayeb, Anna Madill, Christian P Selinger
AIM: To examine patient knowledge and factors influencing knowledge about pregnancy in British women with inflammatory bowel disease (IBD). METHODS: This is a post hoc analysis of a study of female members of Crohn's and Colitis United Kingdom, aged 18-45 years who were sent an online questionnaire recording patient demographics, education, employment, marital status, and disease characteristics. Disease related pregnancy knowledge was recorded using Crohn's and colitis pregnancy knowledge score (CCPKnow)...
September 28, 2016: World Journal of Gastroenterology: WJG
Koroush Ghanadi, Javad Valizadeh, Afshin Hasanvand
INTRODUCTION: One of the forms of inflammatory bowel disease (IBD) that causes inflammation and ulcers in colon is ulcerative colitis (UC). This study was aimed to determine the epidemiological and clinical aspects of patients with ulcerative colitis in the west of Iran. METHODS: In this cross sectional study, we evaluated 150 patients with definite diagnosis of UC who referred to a subspecialty gastroenterology clinic in Khorramabad, Iran. The study was performed from May 2014 to August 2015 by using census method...
2016: SpringerPlus
Margarita V Revzin, Mahan Mathur, Haatal B Dave, Matthew L Macer, Michael Spektor
Pelvic inflammatory disease (PID) is a common medical problem, with almost 1 million cases diagnosed annually. Historically, PID has been a clinical diagnosis supplemented with the findings from ultrasonography (US) or magnetic resonance (MR) imaging. However, the diagnosis of PID can be challenging because the clinical manifestations may mimic those of other pelvic and abdominal processes. Given the nonspecific clinical manifestations, computed tomography (CT) is commonly the first imaging examination performed...
September 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Takeshi Shin, Hiroshi Okada
Inflammatory bowel disease (IBD) predominantly affects young adults. Fertility-related issues are therefore important in the management of patients with IBD. However, relatively modest attention has been paid to reproductive issues faced by men with IBD. To investigate the effects of IBD and its treatment on male fertility, we reviewed the current literature using a systematic search for published studies. A PubMed search were performed using the main search terms "IBD AND male infertility", "Crohn's disease AND male infertility", "ulcerative colitis AND male infertility"...
August 6, 2016: World Journal of Gastrointestinal Pharmacology and Therapeutics
S L Kanis, C J van der Woude
Crohn's disease and ulcerative colitis, referred to as inflammatory bowel disease (IBD), are chronic, relapsing conditions. Patients are often diagnosed at a reproductive age, and therefore questions about fertility and reproductions often arise. Preconceptional counseling is the most important aspect in the management of IBD patients with a pregnancy wish. Patients should be counseled on the influence of IBD and IBD drugs on pregnancy. Most drugs are not related to adverse outcome while used during pregnancy...
2016: Digestive Diseases
Audrey Binette, Kerry Howatt, Ashley Waddington, Robert L Reid
Despite the introduction of promising products into the contraceptive market, the rate of unintended pregnancies remains high. Women with underlying medical conditions should have access to safe and effective contraceptive methods for various reasons, including the potential deleterious effect of the disease on the pregnancy or the effect of the pregnancy on the disease process. Healthcare providers are often confronted with cases in which contraception counseling is problematic due to controversial evidence and persistent myths...
August 22, 2016: Journal of Women's Health
Louise E Glover, Blair Fennimore, Mary Wingfield
The incidence and prevalence of inflammatory bowel disease (IBD) continues to rise with time, signifying its emergence as a global disease. Clinical onset of IBD, comprising Crohn's disease and ulcerative colitis, typically occurs before or at peak reproductive age. Although active disease in female patients is associated with reduced fertility and adverse obstetric outcomes in pregnancy, the molecular mechanisms underlying this altered reproductive course, and its impact on IBD transmission to offspring, remain poorly understood...
November 2016: Inflammatory Bowel Diseases
Roger A Levy, Guilherme R de Jesús, Nilson R de Jesús, Evandro M Klumb
The crucial issue for a better pregnancy outcome in women with autoimmune rheumatic diseases is appropriate planning, with counseling of the ideal timing and treatment adaptation. Drugs used to treat rheumatic diseases may interfere with fertility or increase the risk of miscarriages and congenital abnormalities. MTX use post-conception is clearly linked to abortions as well as major birth defects, so it should be stopped 3months before conception. Leflunomide causes abnormalities in animals even in low doses...
October 2016: Autoimmunity Reviews
V Huang, Y Leung, G C Nguyen, C H Seow
No abstract text is available yet for this article.
2016: Canadian Journal of Gastroenterology & Hepatology
Alison de Lima-Karagiannis, Zuzana Zelinkova-Detkova, Christien Janneke van der Woude
OBJECTIVES: Previous data on inflammatory bowel disease (IBD) relapse during pregnancy mainly originate from retrospective studies. The aim of this study was therefore (i) to evaluate the effect of active disease at conception and IBD disease type on disease relapse during pregnancy and (ii) to study the effects of disease relapse during pregnancy on birth outcomes in a prospective cohort with adequate representation of current treatments. METHODS: From 2008 to 2014, IBD women were recruited from an ongoing prospective clinical cohort...
September 2016: American Journal of Gastroenterology
Daniela Simian, Lilian Flores, Rodrigo Quera, Udo Kronberg, Patricio Ibáñez, Carolina Figueroa, Jaime Lubascher
AIMS AND OBJECTIVES: To assess disease-related knowledge among patients with IBD and to identify the factors that are possibly associated with the knowledge level. BACKGROUND: Disease-related knowledge can positively influence the acceptance of the disease, increase treatment compliance and improve the quality of life in patients with IBD. DESIGN: An observational, cross-sectional study was conducted and prospectively included patients from the IBD program between October 2014 and July 2015...
June 20, 2016: Journal of Clinical Nursing
Shane Killeen, James Gunn, John Hartley
AIM: The medical management of inflammatory bowel disease (IBD) in pregnancy and the puerperum is well defined. Data on surgical management of complicated IBD in this setting are lacking. The study aimed to determine the optimal surgical strategy for medically refractory IBD during pregnancy and the puerperium. METHOD: Three databases were systematically reviewed to identify all published series or case reports of females undergoing surgery for Crohn's disease (CD) or ulcerative colitis (UC) while pregnant or in the puerperium...
June 18, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Alyshah Abdul Sultan, Joe West, Lu Ban, David Humes, Laila J Tata, Kate M Fleming, Catherine Nelson-Piercy, Timothy Card
BACKGROUND: There is limited contemporary population-based evidence on adverse birth outcomes and pregnancy-related complications for women with inflammatory bowel disease (IBD). This study provides such estimates of these risks and assesses variation by IBD type and surgical interventions. METHODS: We calculated the proportion of pregnancies in women with and without IBD between 1997 and 2012 throughout England using linked primary (Clinical Practice Research Datalink) and secondary care (Hospital Episode Statistics) data...
July 2016: Inflammatory Bowel Diseases
Anne Veie Plauborg, Anne Vinkel Hansen, Ester Garne
BACKGROUND: The aim of this study was to describe prescription patterns for azathioprine and corticosteroids for pregnant women with inflammatory bowel diseases (IBD) before, during, and after pregnancy and to describe pregnancy outcomes. METHODS: A cohort composed of all singleton pregnancies in Danish registries from 1996 to 2009 was divided by maternal IBD status: Crohn's disease (CD, n = 827), ulcerative colitis (UC, N = 1361), or no IBD diagnosis (background population, n = 814,231)...
June 2016: Birth Defects Research. Part A, Clinical and Molecular Teratology
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