inflammatory bowel disease in pregnancy

Management

medications in pregnant patients with inflammatory bowel disease

• antibiotics
  • amoxicillin-clavulanate is safe
  • ciprofloxacin is safe
  • metronidazole use is controversial (avoid 1st trimester)
  • avoid rifaximin
• 5-aminosalicylates are safe
• avoid glucocorticoids as planned maintenance therapy
• thiopurines are safe (do not initiate during pregnancy)
• cyclosporine
  • probably safe for acute severe ulcerative colitis
  • may increase risk of gestational diabetes, preeclampsia, preterm birth
  • use only when need is critical
• TNF-alpha inhibitors are safe
  • initial treatment of choic for moderate-severe Crohn's disease
• data limited or insufficient for
  • tacrolimus, tofacitinib, vedolizumab, ustekinumab

More general terms

• pregnancy disorder; obstetric disorder; pregnancy complication
• inflammatory bowel disease