Prognosticul materno-fetal şi managementul bolilor inflamatorii intestinale în sarcină

Inflammatory bowel diseases (IBD) – ulcerative colitis, Chron disease and indeterminate colitis – affect mainly women at childbearing age, resulting in a challenge for obtaining a pregnancy. The aim of the therapeutic management is to obtain a good control of the disease before conception, with a combined medical surveillance throughout pregnancy (gastroenterological, obstetrical and neonatal). The advances in IBD treatment during pregnancy and lactation have resulted in a better maternal-fetal outcome. Weak control of the disease correlates with specific complications, such as misscariage, premature birth, insufficient intrauterine growth, preeclampsia, increased number of caesarean sections, low Apgar score at birth. The association between inflammatory intestinal disease, its treatment and the occurrence of fetal malformations remains controversial, although numerous studies have been conducted to verify this aspect. The introduction of biological therapy in the treatment of inflammatory bowel disease in pregnancy led to a better control of the disease, but brought new challenges for obstetricians and neonatologists.