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Gastroenterologie
a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2021; 75(2): 149–158. doi: 10.48095/ccgh2021149.

Management léčby IBD v těhotenství vyžaduje multidisciplinární přístup

Filip Marek1, Radoslav Hrivnák1, Ivo Rovný1, Petr Jabandžiev2,3, Karolína Poredská4, Vladimír Procházka Orcid.org  1, Dominika Ivanecká1, Vít Weinberger5, Petr Janků5, Lumír Kunovský1,4, Zdeněk Kala Orcid.org  1, Jiří Dolina Orcid.org  6, Daniel Bartušek Orcid.org  7

+ Pracoviště

Souhrn

F. Marek, Z. Kala, R. Hrivnák, I. Rovný, P. Jabandžiev, K. Poredská, J. Dolina, V. Procházka, D. Ivanecká, D. Bartušek, V. Weinberger, P. Janků, L. Kunovský

Crohnova nemoc a ulcerózní kolitida jsou chronická zánětlivá onemocnění střev (IBD – inflammatory bowel disease). V článku je shrnut přístup k léčbě gravidních pacientek s IBD od konzervativní terapie přes endoskopii, zobrazovací metody až po indikace k operačnímu řešení. Pacientky s IBD by měly těhotenství plánovat v době remise onemocnění. Pacientky v remisi mohou mít rovněž komplikace v těhotenství, ale riziko komplikací je nižší než u pacientek s aktivním onemocněním. Zavedená medikace (kromě teratogenního metotrexátu) by měla být ponechána. Dle dostupných dat samotné těhotenství nezhoršuje průběh IBD. Při těžkém relapsu či výskytu komplikací IBD je u těchto pacientek nutná multioborová spolupráce gastroenterologa, chirurga, radiologa a gynekologa. Operační řešení je nutné pouze při akutních komplikacích IBD (akutní těžká kolitida nereagující na medikamentózní terapii, perianální absces a komplikace IBD ve smyslu náhlých příhod břišních – perforace, ileózní stav při stenóze a masivním krvácení).

Klíčová slova

Crohnova nemoc, ulcerózní kolitida, idiopatické střevní záněty, gravidita, chirurgie, endoskopie, porod, relaps



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