General

Ulcerative colitis and Pregnancy

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4 Sep 2016 - General
 

There are 2 important factors of having ulcerative colitis and being pregnant, which are the effect of the disease itself and also the effect of medications for ulcerative colitis. If the disease activity is well controlled  or in clinical remisison, it should not have any negative effect on fertility or pregnancy. If patient has a flare of colitis or having active disease during pregnancy, the risk of fetal loss will be increased. Hence, it is very important to maiantain good control of disease activity before, and during the period of pregnancy. Mesalazine (5-ASA) has a long record of safety in pregnancy, and it should be continue throughout the pregnancy. Sulfasalazine may cause reversible oligospermia, and it should be replaced with new 5-ASA agents, if the male partner (with ulcerative colitis) is planning to start a family.  How about other medications for inflammatory bowel disease, like azathioprine, steroid, and anti- tumor necrosis factor agents ?? 

Thank you for tagging us Kathleen Peralta I have no experience with treatment of pregnant women with ulcerative colitis. Basing on pregnancy category, thiopurines (drug class of azathioprine) are classified as pregnancy category D. However, azathioprine has been re-classified as safe for pregnant women. Anti-tumor necrosis factor is classified as pregnancy category B. As ...
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Kathleen Peralta thank you for the tag :) I although have not treated a pregnant patient with ulcerative colitis so I have no personal experience to share. I do think although that it would be important to keep the flares at bay during pregnancy as they can be detrimental. Now for "azathioprine, steroid, and anti- tumor necrosis factor agents" I would've thought that they would interfere with normal...
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Steroid usage is considered of low risk in pregnancy, and should be given for the same indications as non-pregnant patient with colitis. If possible, it should be avoided in first trimester due to risk of oral clefts. Azathioprine should be continued during pregnancy if the colitis is not manageable with other medications. Study showed that thiopurine exposure was associated with preterm birth, but not with congenital abnormalities or low birth weight. Anti- tumor necrosis factor (Infliximab, a...
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Thank you for this information. I am not suffering from Ulcerative Colitis and had a healthy pregnancy but this is worth sharing to my friends who may be planning to start a family. What are you trying to ask in this question, "How about other medications for inflammatory bowel disease, like azathioprine, steroid, and anti- tumor necrosis factor agents ?" Are you asking if these are safe to take before and during pregnancy? I may not be the best person to answer this but I hope someon...
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