Introduction A European consensus on issues surrounding IBD in pregnancy was published in 2010.1 We conducted a questionnaire to gain information about knowledge and management of IBD in pregnancy in the Northern region in both gastroenterology consultants and specialist trainees.
Methods A questionnaire assessing the management of IBD in pregnancy and pre-conception was devised. 34 questionnaires were given out at a joint trainee and trainer teaching session and were completed anonymously.
Results 34 questionnaires were returned; 16 consultants, 14 trainees, 4 not specified.
Pre-conception 22/34 (65%) routinely ask women of childbearing age about intentions to conceive, 16/34 (47%) routinely ask about contraception. If intending to conceive 24/34 (71%) would routinely give supplements (19/24 (79%) specified folate).
Pre natal 29/34 (85%) would routinely refer to obstetrician on discovery of pregnancy, 24/34 (71%) would see more frequently during the pregnancy. 27/34 (79%) would advise Caesarean section (CS) in certain patient groups; 2 would not advise CS and 5 did not know. The suggested indications for CS by respondents were: perianal disease (24) ileoanal pouch (6), previous CS (1), uncontrolled disease (1), previous surgery (2). 20/34 would recommend the flu jab in pregnancy.
Postnatal 10/34 (29%) were aware of live vaccinations that may be contraindicated in a neonate (7/10 were trainees).
Medications specific questions were asked about which medications would be recommended to be stopped in the pre and ante-natal periods and which were considered safe in breastfeeding (See Table).
Conclusion Within the North East Region there is a varied consensus to the management of IBD preconception and during pregnancy both in terms of medication and indication for surgery. This is despite the European consensus document. There are areas which could be improved; only 6 of 27 who would consider CS in certain groups would consider it for ileoanal pouch and although this should be tailored to each individual patient guidelines would suggest that CS be strongly considered in those with a pouch and perhaps further education in this area would be beneficial. Although the majority would ask about plans for conceiving, discussion of contraception occurs in less than half of consultations. We would advocate a combined approach for these patients in conjunction with an interested gastroenterologist and obstetrician in order to optimise management and outcomes.
Janneke van der Woude et al. J Crohns Colitis 2010:4:493–510
Disclosure of Interest None Declared.
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