Management léčby IBD v těhotenství vyžaduje multidisciplinární přístup


Autoři: F. Marek 1;  Z. Kala 1;  R. Hrivnák 1;  I. Rovný 1;  P. Jabandžiev 2,3;  K. Poredská 4;  J. Dolina 4;  V. Procházka 1;  D. Ivanecká 1;  D. Bartušek 5;  V. Weinberger 6;  P. Janků 6;  L. Kunovsky 1,4
Působiště autorů: Department of Surgery, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic 1;  Department of Pediatrics, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic 2;  Central European Institute of Technology, Masaryk University, Brno, Czech Republic 3;  Department of Gastroenterology and Internal Medicine, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic 4;  Department of Radiology and Nuclear Medicine, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic 5;  Department of Gynecology and Obstetrics, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic 6
Vyšlo v časopise: Gastroent Hepatol 2021; 75(2): 149-158
Kategorie: IBD: review article
doi: 10.48095/ccgh2021149

Souhrn

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).

Konflikt zájmů: Autoři deklarují, že text článku odpovídá etickým standardům, byla dodržena anonymita pacientů a prohlašují, že v souvislosti s předmětem článku nemají finanční, poradenské ani jiné komerční zájmy.

Publikační etika: Příspěvek nebyl dosud publikován ani není v současnosti zaslán do jiného časopisu pro posouzení. Autoři souhlasí s uveřejněním svého jména a e-mailového kontaktu v publikovaném textu.

Dedikace: Tato práce byla podpořena projektem MZd ČR – koncepční vývoj výzkumné organizace (FNBr, 65269705).

Redakční rada potvrzuje, že rukopis práce splnil ICMJE kritéria pro publikace zasílané do bio­medicínských časopisů.

Klíčová slova:

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


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Štítky
Dětská gastroenterologie Gastroenterologie a hepatologie Chirurgie všeobecná

Článek vyšel v časopise

Gastroenterologie a hepatologie

Číslo 2

2021 Číslo 2

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