Surgery due to Inflammatory Bowel Disease During Pregnancy: Mothers and Offspring Outcomes From an ECCO Confer Multicentre Case Series [Scar Study]


CHAPARRO Maria KUNOVSKÝ Lumír AGUAS Mariam LIVNE Moran RIVIERE Pauline SHITRIT Ariella Bar-Gil MYRELID Par ARROYO Maite BARREIRO-DE Acosta Manuel BAUTISTA Michelle BIANCONE Livia BIRON Irit Avni BOYSEN Trine CARPIO Daniel CASTRO Beatriz DRAGONI Gabriele ELLUL Pierre HOLUBAR Stefan D MIGUEL Angel de Jorge LEO Eduardo MANCENIDO Noemi MOENS Annick MOLNAR Tamas PATRICIA Ramirez de la Piscina RICANEK Petr SEBKOVA Ladislava SEMPERE Laura TEICH Niels GISBERT Javier P JULSGAARD Mette

Year of publication 2022
Type Article in Periodical
MU Faculty or unit

Faculty of Medicine

Keywords Inflammatory bowel disease; Crohn's disease; ulcerative colitis; pregnancy; gestation; surgery
Description Aims i] To evaluate the evolution of pregnancies and offspring after inflammatory bowel disease [IBD] surgery during pregnancy; and ii] to describe the indications, the surgical techniques, and the frequency of caesarean section concomitant with surgery. Methods Patients operated on due to IBD during pregnancy after 1998 were included. Participating clinicians were asked to review their databases to identify cases. Data on patients' demographics, IBD characteristics, medical treatments, IBD activity, pregnancy outcomes, surgery, delivery, and foetal and maternal outcomes, were recorded. Results In all, 44 IBD patients were included, of whom 75% had Crohn's disease; 18% of the surgeries were performed in the first trimester, 55% in the second, and 27% in the third trimester. One patient had complications during surgery, and 27% had postsurgical complications. No patient died. Of deliveries, 70% were carried out by caesarean section. There were 40 newborns alive. There were four miscarriages/stillbirths [one in the first, two in the second, and one in the third trimester]; two occurred during surgery, and another two occurred 2 weeks after surgery; 14% of the surgeries during the second trimester and 64% of those in the third trimester ended up with a simultaneous caesarean section or vaginal delivery. Of the 40 newborns, 61% were premature and 47% had low birth weight; 42% of newborns needed hospitalisation [25% in the intensive care unit]. Conclusions IBD surgery during pregnancy remains an extremely serious situation. Therefore, surgical management should be performed in a multidisciplinary team, involving gastroenterologists, colorectal surgeons, obstetricians, and neonatal specialists.

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