从怀孕前到产后的炎症性肠病的临床管理
Loren G Rabinowitz1, Ajay Gade1, Tina Deyhim1
1Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
在生殖年期间管理炎症性肠病 (IBD) 需要计划. 大多数IBD疗法,包括生物药物,在怀孕和母乳养期间是安全的,促进最佳的母亲和婴儿结果.
科学领域:
- 胃肠病学和肝病学
- 产科和妇科 产科和妇科
- 生殖医学 生殖医学
背景情况:
- 炎症性肠病 (IBD),包括克罗恩氏病和性结肠炎,经常影响妇女在他们的主要生殖年.
- 女性IBD患者在生育能力,受孕,怀孕,分娩和哺乳方面遇到不同的挑战.
- 关于怀孕期间和产后期IBD最佳管理的现有知识差距仍然存在.
研究的目的:
- 审查IBD妇女在整个生育年龄所面临的挑战.
- 提供一种实用,基于证据的方法来管理不同生殖阶段的IBD.
- 提供关于怀孕前咨询,怀孕管理,分娩,产后护理和母乳养的指导.
主要方法:
- 对现有研究和临床指导方针进行全面的文献审查.
- 关于IBD治疗在怀孕和哺乳期间的安全性和有效性的综合证据.
- 分析IBD患者与母亲和胎儿健康相关的结果.
主要成果:
- 疾病缓解是有利于孕产妇和胎儿的最重要的预测因素.
- 大多数IBD治疗方法,特别是生物药物,在怀孕和母乳养期间被认为是安全的.
- 对IBD的小分子疗法通常是禁忌的,原因是潜在的原性风险或安全性数据不足.
结论:
- 从怀孕前到产后,有效管理IBD需要积极的规划,多学科的协作和以患者为中心的护理.
- 在怀孕和哺乳期间,建议继续大多数IBD疗法,包括生物药物.
- 治疗到目标的策略与勤奋的产后监测相结合,对于预防疾病爆发和确保母亲和儿童的最佳结果至关重要.
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