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Abstract
Chronic idiopathic ulcerative colitis affects patients during the peak of their fertile years, therefore, pregnancy and lactation represent a really important medical topic. The maintenance of previous treatment, as well as preconception counseling to optimize the health of the patients is important to have a safe pregnancy with good results. Thalidomide and methotrexate are absolutely contraindicated during pregnancy and lactation. However, therapy with 5-aminosalicylic acid preparations, glucocorticoids, thiopurines, and TNF inhibitors is acceptable during pregnancy and lactation. The decision to use any agent during pregnancy should be based on the clinical context, the risks associated with the individual drugs, and gestational age. It is recommended to base the decision for cesarean delivery on obstetric considerations and not only on the diagnosis of ulcerative colitis.
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References
Tomczak MF, Friedman S, Blumberg RS. Enfermedad inflamatoria intestinal. En: Méndez-Sánchez N. eds. Gastroenterología, 3e New York, NY: 2017 McGraw-Hill. Disponible a partir de: http://accessmedicina.mhmedical.com.ezproxy.sibdi.ucr.ac.cr:2048/content.aspx?bookid=2369§ionid=184730221
Crooks B, Barnes T, Limdi JK. Vedolizumab in the treatment of inflammatory bowel disease: evolving paradigms. Drugs Context [Internet]. 2020;9:1–15. Doi: http://dx.doi.org/10.7573/dic.2019-10-2
Cunningham F, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, Spong CY. eds. Trastornos Gastrointestinales en Williams Obstetricia, 25. 2017 New York, NY: McGraw-Hill. Disponible a partir de: http://accessmedicina.mhmedical.com.ezproxy.sibdi.ucr.ac.cr:2048/content.aspx?bookid=2739§ionid=230097903
Huernos SP. Revisión de la enfermedad inflamatoria intestinal durante el embarazo y la lactancia. Acta Gastroenterol Latinoam. 2017;46:340-349
Chang S, Hudesman D. First-line biologics or small molecules in inflammatory bowel disease: A practical guide for the clinician. Curr Gastroenterol Rep [Internet]. 2020;22(2):7. Doi: http://dx.doi.org/10.1007/s11894-020-0745-y
ACOG committee opinion no. 776: Immune modulating therapies in pregnancy and lactation: Immune modulating therapies in pregnancy and lactation. Obstet Gynecol [Internet]. 2019;133(4):e287–95. Doi: http://dx.doi.org/10.1097/AOG.0000000000003176
García Caeiro ÁL, Rey Liste MT, Ventosa Rial JJ, Alonso Fachado A. Aten Primaria [Internet]. 2017; 49(10): 622–3. Doi: http://dx.doi.org/10.1016/j.aprim.2017.03.017
U.S. Department of Health and Human Services. Food and Drug Administration. Pregnancy, Lactation and Reproductive Potential: Labeling for Human Prescription Drug and Biological Products-Content and Format. Guidance for Industry. [actualizado en 2015]. Disponible a partir de: https://www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation/guidances/ucm450636.pdf6
Watanabe C, Nagahori M, Fujii T, Yokoyama K, Yoshimura N, Kobayashi T, et al. Non-adherence to medications in pregnant ulcerative colitis patients contributes to disease flares and adverse pregnancy outcomes. Dig Dis Sci [Internet]. 2021; 66(2): 577–86. Doi: http://dx.doi.org/10.1007/s10620-020-06221-6
Nguyen GC, Seow CH, Maxwell C, Huang V, Leung Y, Jones J, et al. The Toronto consensus statements for the management of inflammatory bowel disease in pregnancy. Gastroenterology [Internet]. 2016;150(3):734-757. Doi: http://dx.doi.org/10.1053/j.gastro.2015.12.003
Restellini S, Biedermann L, Hruz P, Mottet C, Moens A, Ferrante M, et al. Update on the management of inflammatory bowel disease during pregnancy and breastfeeding. Digestion [Internet]. 2020;101 Supl. 1(Supl. 1):27–42. Doi: http://dx.doi.org/10.1159/000502886
Ungaro R, Mehandru S, Allen PB, Peyrin-Biroulet L, Colombel J-F. Ulcerative colitis. Lancet [Internet]. 2017; 389(10080):1756–70. Doi: http://dx.doi.org/10.1016/s0140-6736(16)32126-2
Nielsen OH, Maxwell C, Hendel J. IBD medications during pregnancy and lactation. Nat Rev Gastroenterol Hepatol [Internet]. 2014;11(2):116–27. Doi: http://dx.doi.org/10.1038/nrgastro.2013.135
Speichinger E, Holschneider CH. Trastornos quirúrgicos en el embarazo. En: DeCherney A.H. Nathan L, Laufer N, Roman A.S. (Eds.), Diagnóstico y tratamiento ginecoobstétrico, 11e. McGraw-Hill. Disponible a partir de: https://accessmedicina-mhmedicalcom.ezproxy.sibdi.ucr.ac.cr/content.aspx?bookid=1494§ionid=98127185
Bar Oz B, Hackman R, Einarson T, Koren G. Pregnancy outcome after cyclosporine therapy during pregnancy: A meta-analysis1. Transplantation [Internet]. 2001 [citado el 8 de marzo de 2022];71(8):1051–5. Disponible a partir de: https://pubmed.ncbi.nlm.nih.gov/11374400/
Agrawal M, Kim ES, Colombel J-F. JAK inhibitors safety in ulcerative colitis: Practical implications. J Crohns Colitis [Internet]. 2020;14(Supl. 2):S755–60. Doi: http://dx.doi.org/10.1093/ecco-jcc/jjaa017
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