Purpose: Women of childbearing age with inflammatory bowel disease (IBD) in South China were studied to understand the effects of IBD on pregnancy outcomes. Materials and Methods: One hundred thirty-nine women treated...Purpose: Women of childbearing age with inflammatory bowel disease (IBD) in South China were studied to understand the effects of IBD on pregnancy outcomes. Materials and Methods: One hundred thirty-nine women treated at two large IBD centers participated. Pregnancy outcome data were collected by telephone interviews. Results: Ninety patients (90/139;64.7%) did not pursue pregnancy after IBD diagnosis because of concerns regarding adverse effects. Fifteen Crohn’s disease (CD) and 12 ulcerative colitis (UC) patients pursued pregnancy and achieved successful conception. Twenty-five patients were treated with drugs before pregnancy;however, 15 (15/25;60%) discontinued the use of all drugs 3 months before pregnancy. The other 10 patients continued mesalazine and one continued azathioprine during pregnancy. Four CD and five UC patients had mild disease at conception;the others were in remission. Two CD patients and one UC patient experienced mild disease relapse during pregnancy. They refused all drugs except mesalazine. One UC patient with mild disease during pregnancy had pregnancy-induced hypertension. All newborns were healthy. There was no difference between pregnancy outcomes of CD and UC patients (P > 0.05). No relationship was found between disease activity and pregnancy outcomes (P > 0.05). Patients with active disease during pregnancy tended to choose cesarean delivery, especially in CD patients with active disease (P = 0.028). Conclusion: Many female IBD patients may not pursue pregnancy because of concerns regarding adverse effects on the pregnancy. Patients were more willing to conceive during disease remission. Some refused all IBD medications except mesalazine. Relapse was uncommon or mild during pregnancy. Disease activity had an obvious effect on the delivery mode of CD patients.展开更多
Introduction Bowel stricture is a common complication in patients with Crohn’s disease(CD),which often requires surgery[1,2].Notably,25%of patients develop at least one small bowel stricture[3].Endoscopic interventio...Introduction Bowel stricture is a common complication in patients with Crohn’s disease(CD),which often requires surgery[1,2].Notably,25%of patients develop at least one small bowel stricture[3].Endoscopic intervention has emerged as a feasible and minimally invasive adjunct or alternative to surgery.However,endoscopic intervention for small bowel strictures poses a technical challenge for gastroenterologists.Deep small bowel strictures beyond the terminal ileum are only accessible to device-assisted enteroscopy,including balloon-assisted enteroscopy(BAE).BAE-based endoscopic balloon dilation(EBD)has been reported to be safe and effective for small bowel strictures from CD[4].展开更多
文摘Purpose: Women of childbearing age with inflammatory bowel disease (IBD) in South China were studied to understand the effects of IBD on pregnancy outcomes. Materials and Methods: One hundred thirty-nine women treated at two large IBD centers participated. Pregnancy outcome data were collected by telephone interviews. Results: Ninety patients (90/139;64.7%) did not pursue pregnancy after IBD diagnosis because of concerns regarding adverse effects. Fifteen Crohn’s disease (CD) and 12 ulcerative colitis (UC) patients pursued pregnancy and achieved successful conception. Twenty-five patients were treated with drugs before pregnancy;however, 15 (15/25;60%) discontinued the use of all drugs 3 months before pregnancy. The other 10 patients continued mesalazine and one continued azathioprine during pregnancy. Four CD and five UC patients had mild disease at conception;the others were in remission. Two CD patients and one UC patient experienced mild disease relapse during pregnancy. They refused all drugs except mesalazine. One UC patient with mild disease during pregnancy had pregnancy-induced hypertension. All newborns were healthy. There was no difference between pregnancy outcomes of CD and UC patients (P > 0.05). No relationship was found between disease activity and pregnancy outcomes (P > 0.05). Patients with active disease during pregnancy tended to choose cesarean delivery, especially in CD patients with active disease (P = 0.028). Conclusion: Many female IBD patients may not pursue pregnancy because of concerns regarding adverse effects on the pregnancy. Patients were more willing to conceive during disease remission. Some refused all IBD medications except mesalazine. Relapse was uncommon or mild during pregnancy. Disease activity had an obvious effect on the delivery mode of CD patients.
基金This work was supported by the National Natural Science Foundation of China(No.81400603)Guangdong Natural Science Foundation(No.2015A030310190)the Science and Technology Planning Project of Guangdong Province(No.2015B020229001).
基金supported in part by the National Natural Science Foundation of China[grant numbers 81870382,82100544]Guangdong Basic and Applied Basic Research Foundation[grant number 2020A1515111102]+2 种基金China Postdoctoral Science Foundation[grant number 2021M703743]Postdoctoral Foundation of the Sixth Hospital of Sun Yat-sen University[grant number R20210217202112997]National Key Clinical Discipline.
文摘Introduction Bowel stricture is a common complication in patients with Crohn’s disease(CD),which often requires surgery[1,2].Notably,25%of patients develop at least one small bowel stricture[3].Endoscopic intervention has emerged as a feasible and minimally invasive adjunct or alternative to surgery.However,endoscopic intervention for small bowel strictures poses a technical challenge for gastroenterologists.Deep small bowel strictures beyond the terminal ileum are only accessible to device-assisted enteroscopy,including balloon-assisted enteroscopy(BAE).BAE-based endoscopic balloon dilation(EBD)has been reported to be safe and effective for small bowel strictures from CD[4].
