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Management der chronisch-entzündlichen Darmerkrankungen während der Schwangerschaft

Management of chronic inflammatory bowel disease during pregnancy

  • Leitthema
  • Published:
Der Gynäkologe Aims and scope

Zusammenfassung

Hintergrund

Chronisch-entzündliche Darmerkrankungen (CED) betreffen oft Frauen im gebärfähigen Alter. Das therapeutische Management von CED-Patientinnen während einer geplanten oder laufenden Schwangerschaft stellt eine Herausforderung für alle behandelnden Ärzte dar.

Ziel der Arbeit

Darstellung der aktuellen therapeutischen Empfehlungen bei schwangeren CED-Patientinnen mit besonderem Schwerpunkt auf der Durchführung von Magen- und Darmspiegelungen.

Ergebnisse/Diskussion

Eine geplante Konzeption sollte bevorzugt in einer mindestens 3 Monate dauernden klinischen Remission stattfinden. Bei entsprechender Indikation wird empfohlen, eine Magen- oder Darmspiegelung in anästhesiologischer Bereitschaft bevorzugt mit Propofol und Pethidin durchzuführen. Aminosalizylate, Glukokortikoide, Thiopurine und TNF(Tumornekrosefaktor)-α-Inhibitoren gelten als relativ sichere Therapeutika während einer Schwangerschaft und können bei entsprechender Indikation eingesetzt werden. TNF-α-Inhibitoren sollten – falls möglich – vor Beginn des 3. Trimesters pausiert werden.

Abstract

Background

Chronic inflammatory bowel disease (CIBD) often affects women of childbearing age. The management of a planned or successful pregnancy in CIBD patients is a challenge for all physicians.

Objectives

This review article summarizes the currently available data on pregnant CIBD patients with particular attention to gastroscopy, colonoscopy and therapeutic drug interventions.

Results and discussion

The optimal time for conception is during remission and a minimum duration of remission of 3 months is recommended. Justifiable indications for gastroscopy or colonoscopy should be preferably performed with propofol and pethidine in anesthesiological standby. When indicated aminosalicylates, glucocorticoids, thiopurines and tumor necrosis factor alpha (TNF-alpha) inhibitors can be safely used during pregnancy. If possible, TNF-alpha inhibitors should be terminated before the beginning of the third trimester.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. A. Amanzada gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Klinik für Gastroenterologie II, Universitätsmedizin Göttingen, Georg-August-Universität Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland

    A. Amanzada

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Amanzada, A. Management der chronisch-entzündlichen Darmerkrankungen während der Schwangerschaft. Gynäkologe 48, 131–138 (2015). https://doi.org/10.1007/s00129-014-3409-x

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  • DOI: https://doi.org/10.1007/s00129-014-3409-x

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