Surgery Due to Inflammatory Bowel Disease During Pregnancy: Mothers and Offspring Outcomes From an Ecco Confer Multicentre Case Series (Scar Study)

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

DOI

  • María Chaparro, Hospital Universitario de la Princesa
  • ,
  • Lumír Kunovský, Masaryk University
  • ,
  • Mariam Aguas, Hospital Universitario y Politécnico La Fe and CIBERehd. Valencia. Spain
  • ,
  • Moran Livne, Chaim Sheba Med Ctr, Chaim Sheba Medical Center, Inst Oncol
  • ,
  • Pauline Rivière, Bordeaux University Hospitals
  • ,
  • Ariella Bar-Gil Shitrit, Hebrew Univ Jerusalem, Hebrew University of Jerusalem, Racah Inst Phys
  • ,
  • Pär Myrelid, Linköping University Hospital and Department of Biomedical and Clinical Sciences
  • ,
  • Maite Arroyo, Hospital Clínico Universitario Lozano Blesa and CIBERehd
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  • Manuel Barreiro-de Acosta, Complejo Hospitalario Universitario de Santiago
  • ,
  • Michelle Bautista, Hospital Joan XXIII
  • ,
  • Livia Biancone, Univ Tor Vergata, University of Rome Tor Vergata, Orthopaed Surg
  • ,
  • Irit Avni Biron, IBD Center, Humanitas Clinical and Research Institute, Rozzano, Milan, Italy and Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy.
  • ,
  • Trine Boysen, Amager and Hvidovre Hospital, University Hospital of Copenhagen, Hvidovre
  • ,
  • Daniel Carpio, Complexo Hospitalario Universitario de Pontevedra
  • ,
  • Beatriz Castro, Hospital Universitario Marqués de Valdecilla and IDIVAL. Santander
  • ,
  • Gabriele Dragoni, University Hospital of Careggi
  • ,
  • Pierre Ellul, Mater Dei Hospital
  • ,
  • Stefan D Holubar, Cleveland Clinic Foundation, Cleveland, OH, USA.
  • ,
  • Miguel Ángel de Jorge, Hospital de Cabuenes
  • ,
  • Eduardo Leo, Hospital Universitario Virgen del Rocio
  • ,
  • Noemí Manceñido, Hospital Universitario Infanta Sofía. San Sebastián de los Reyes
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  • Annick Moens, Leuven Centre for Algology & Pain Management, University Hospitals Leuven, University Hospitals Leuven, Pellenberg, Belgium.
  • ,
  • Tamás Molnár, Univ Szeged, Szeged University, Cardiol Ctr
  • ,
  • Patricia Ramírez de la Piscina, Hospital Universitario de Araba (sede Txagorritxu y sede Santiago)
  • ,
  • Petr Ricanek, Nevroklinikken, Akershus Universitetssykehus
  • ,
  • Ladislava Sebkova, Azienda Ospedaliera Pugliese-Ciaccio
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  • Laura Sempere, Hospital General Universitario de Alicante and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Alicante, Spain.
  • ,
  • Niels Teich, Director, Unit for Innovative Healthcare Practice & Technology, Division of General Internal Medicine, Brigham and Women's Hospital and, Harvard Medical School, Boston, MA.
  • ,
  • Javier P Gisbert, Hospital Universitario de la Princesa
  • ,
  • Mette Julsgaard
  • ECCO CONFER taskforce

AIMS: i) To evaluate the evolution of pregnancies and offspring after inflammatory bowel disease (IBD) surgery during pregnancy; and ii) to describe the indications, the surgical techniques, and the frequency of caesarean section concomitant to surgery.

METHODS: Patients operated on due to IBD during pregnancy after 1998 were included. Participating clinicians were asked to review their databases to identify cases. Data on patients' demographics, IBD characteristics, medical treatments, IBD activity, pregnancy outcomes, surgery, delivery, foetal and maternal outcomes, were recorded.

RESULTS: Forty-four IBD patients were included, 75% had Crohn's disease. Eighteen percent of the surgeries were performed in the 1 st trimester, 55% in the 2 nd, and 27% in the 3 rd trimester. One patient had complications during surgery, and 27% had postsurgical complications. No patient died. Seventy percent of deliveries were carried out by caesarean section. There were 40 newborns alive and 4 miscarriages/stillbirths (1 in the 1 st, 2 in the 2 nd, and 1 in the 3 rd trimester): 2 occurred during surgery, and another 2 occurred 2 weeks after surgery. Fourteen percent of the surgeries during the 2 nd trimester and 64% of those in the 3 rd trimester ended up with a simultaneous cesarean section or vaginal delivery. Of the 40 newborns, 61% were premature, and 47% had low birth weight; 42% of newborns needed hospitalisation (25% in the intensive care unit).

CONCLUSIONS: IBD surgery during pregnancy remains an extremely serious situation. Therefore, surgical management should be performed in a multidisciplinary team, involving gastroenterologists, colorectal surgeons, obstetricians and neonatal specialists.

OriginalsprogEngelsk
TidsskriftJournal of Crohn's & colitis
Vol/bind16
Nummer9
Sider (fra-til)1428-1435
Antal sider8
ISSN1873-9946
DOI
StatusUdgivet - sep. 2022

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