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Declaración de consenso mundial sobre el manejo del embarazo en la enfermedad inflamatoria intestinal
Uma Mahadevan1, Cynthia H Seow2, Edward L Barnes3
1Division of Gastroenterology, Department of Medicine, University of California, San Francisco, California, USA.
The American journal of gastroenterology
|August 27, 2025
Resumen
Este estudio ofrece una guía global para el manejo de la enfermedad inflamatoria intestinal (EII) durante el embarazo, con el objetivo de mejorar los resultados para las madres y los bebés mediante la consolidación de las recomendaciones de los expertos sobre los tratamientos de la EII en mujeres embarazadas.
Área de la Ciencia:
- Gastroenterología y Hepatología
- Obstetricia y ginecología
- Inmunología
Sus antecedentes:
- El embarazo en mujeres con enfermedad inflamatoria intestinal (EII) presenta desafíos significativos debido a la limitada investigación de alta calidad y datos sobre la seguridad de los medicamentos.
- La falta de conocimiento integral entre los pacientes y los proveedores contribuye a las prácticas de atención variadas, lo que afecta las tasas de embarazo, la adherencia a los medicamentos y los resultados materno-fetal.
- Las directrices internacionales contradictorias complican aún más las decisiones de gestión para los médicos y los pacientes.
Objetivo del estudio:
- Establecer un consenso global y proporcionar orientación práctica basada en datos para el cuidado de las mujeres embarazadas con EII.
- Abordar las lagunas de conocimiento y estandarizar las mejores prácticas en el manejo de la EII durante el embarazo.
- Mejorar los resultados del embarazo y la salud materna de las mujeres con EII en todo el mundo.
Principales métodos:
- Un Consorcio de Consenso Global de 39 expertos en EII y 7 defensores de los pacientes se reunió para revisar los datos existentes.
- Se utilizó la metodología GRADE para las recomendaciones basadas en la evidencia cuando existían datos suficientes.
- El proceso RAND se utilizó para el consenso de expertos en áreas que carecían de datos publicados sólidos.
Principales resultados:
- El consorcio abordó 10 categorías temáticas clave relevantes para el manejo de la EII en el embarazo.
- Se formularon un total de 34 recomendaciones GRADE basadas en las pruebas disponibles.
- Se elaboraron declaraciones de consenso para orientar la práctica clínica cuando los datos eran limitados.
Conclusiones:
- La guía desarrollada tiene como objetivo estandarizar y mejorar la atención de las mujeres embarazadas con EII a nivel mundial.
- Las recomendaciones priorizan la salud materna como crucial para apoyar la salud infantil.
- Esta iniciativa busca reducir la confusión y mejorar la coherencia en el manejo de la EII durante el embarazo.
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