Surgery Due to Inflammatory Bowel Disease During Pregnancy: Mothers and Offspring Outcomes From an Ecco Confer Multicentre Case Series (Scar Study).
Por:
Chaparro M, Kunovský L, Aguas M, Livne M, Rivière P, Shitrit AB, Myrelid P, Arroyo M, Barreiro-de Acosta M, Bautista M, Biancone L, Avni Biron I, Boysen T, Carpio D, Castro B, Dragoni G, Ellul P, Holubar SD, de Jorge MÁ, Leo E, Manceñido N, Moens A, Molnár T, Ramírez de la Piscina P, Ricanek P, Sebkova L, Sempere L, Teich N, Gisbert JP, Julsgaard M and ECCO CONFER taskforce
Publicada:
8 sep 2022
Ahead of Print:
4 abr 2022
Resumen:
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.
Filiaciones:
Chaparro M:
Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid. Spain
Kunovský L:
Department of Surgery, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic
Aguas M:
Hospital Universitario y Politécnico La Fe and CIBERehd. Valencia. Spain
Livne M:
Sheba Medical Center, Tel Hashomer, Israel
Rivière P:
Bordeaux University Hospitals, Gastroenterology department, Bordeaux, France
Shitrit AB:
Digestive diseases institute, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
Myrelid P:
Department of Surgery, Linköping University Hospital and Department of Biomedical and Clinical Sciences, Linköping University
Arroyo M:
Hospital Clínico Universitario Lozano Blesa and CIBERehd, IIS Aragón. Zaragoza, Spain
Barreiro-de Acosta M:
Complejo Hospitalario Universitario de Santiago, Santiago de Compostela. Spain
Bautista M:
Hospital Joan XXIII, Tarragona, Spain
Biancone L:
University of Rome "Tor Vergata", Rome, Italy
Avni Biron I:
IBD center, Gastroenterology Division, Rabin medical center, Petach Tikva, Israel
Boysen T:
Hvidovre University Hospital, Hvidovre, Denmark
Carpio D:
Complexo Hospitalario Universitario de Pontevedra, Instituto de Investigación Sanitaria Galicia Sur, Pontevedra, Spain
Castro B:
Hospital Universitario Marqués de Valdecilla and IDIVAL. Santander, Spain
Dragoni G:
Careggi University Hospital, Florence, Italy
Ellul P:
Mater Dei Hospital, Msida, Malta
Holubar SD:
Cleveland Clinic Foundation, Cleveland, USA
de Jorge MÁ:
Hospital de Cabueñes, Gijón, Spain
Leo E:
Hospital Universitario Virgen del Rocío, Sevilla, Spain
Manceñido N:
Hospital Universitario Infanta Sofía. San Sebastián de los Reyes, Spain
Moens A:
University hospitals Leuven, Belgium
Molnár T:
University of Szeged, Albert Szent-Györgyi Medical School, Department of Internal Medicine, Szeged, Hungary
Ramírez de la Piscina P:
Hospital Universitario de Araba (sede Txagorritxu y sede Santiago), Álava, Spain
Ricanek P:
Akershus universitetssykehus, Norway
Sebkova L:
Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy
:
Hospital General Universitario de Alicante and CIBERehd, Alicante, Spain
Teich N:
Practice for internal medicine, Leipzig, Germany
Gisbert JP:
Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid. Spain
Julsgaard M:
Aarhus University Hospital, Aarhus, Denmark
Green Accepted
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