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inflammatory bowel disease in pregnancy
Management:
medications in pregnant patients with inflammatory bowel disease
- antibiotics
- amoxicillin-clavulanate is safe
- ciprofloxacin is safe
- metronidazole use is controversial (avoid 1st trimester)
- avoid rifaximin
- 5-aminosalicylates are safe
- avoid glucocorticoids as planned maintenance therapy
- thiopurines are safe (do not initiate during pregnancy)
- cyclosporine
- probably safe for acute severe ulcerative colitis
- may increase risk of gestational diabetes, preeclampsia, preterm birth
- use only when need is critical
- TNF-alpha inhibitors are safe
- initial treatment of choic for moderate-severe Crohn's disease [2]
- data limited or insufficient for
- tacrolimus, tofacitinib, vedolizumab, ustekinumab
General
pregnancy disorder; obstetric disorder; pregnancy complication
inflammatory bowel disease
References
- Mahadevan U et al.
Drug safety and risk of adverse outcomes for pregnant patients
with inflammatory bowel diseases.
Gastroenterology 2016 Oct 18
PMID: 27769809
- Medical Knowledge Self Assessment Program (MKSAP) 17,
American College of Physicians, Philadelphia 2015