Pregnancy, delivery, and pouch function after heal pouch-anal anastomosis for ulcerative colitis

被引:82
作者
Ravid, A [1 ]
Richard, CS
Spencer, LM
O'Connor, BI
Kennedy, ED
MacRae, HM
Cohen, Z
McLeod, RS
机构
[1] Univ Toronto, Mt Sinai Hosp, IBD Res Unit, Toronto, ON M5G 1X5, Canada
[2] Univ Toronto, Samuel Lunenfeld Res Inst, Div Gen Surg, Toronto, ON M5G 1X5, Canada
[3] Univ Toronto, Dept Surg, Toronto, ON M5G 1X5, Canada
关键词
inflammatory bowel disease; ulcerative colitis; ileal pouch-anal anastomosis; pregnancy; delivery;
D O I
10.1007/s10350-004-6411-x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
PURPOSE: This study was designed to evaluate the pregnancies, method of delivery, and functional results of females with chronic ulcerative colitis who have an ileal pouch-anal anastomosis. METHODS: A mailed questionnaire was sent to all females with an ileal pouch-anal anastomosis for chronic ulcerative colitis. Information on the pregnancy, method of delivery, and outcome was collected. Those females who had a successful pregnancy and delivery were contacted by telephone to clarify results and determine pouch functional results. Other clinical information was obtained from the Mount Sinai Hospital Inflammatory Bowel Disease database. RESULTS: Thirty-eight subjects had 67 pregnancies. Of these, 29 subjects had 49 deliveries. There were 25 vaginal deliveries and 24 cesarean sections. There were two pouch-related complications during the pregnancies and four pouch-related complications postpartum. All were treated nonoperatively. Stool frequency and day and night incontinence were increased during pregnancy in most subjects, but after delivery, prepregnancy function was restored in 24 (83 percent) of them. Five subjects (17 percent) had some degree of permanent deterioration in pouch function. Of these, three had vaginal deliveries and two had cesarean sections. Multiple births and birth weight were not found to adversely affect subsequent pouch function. CONCLUSION: Pregnancy is safe in females with ileal pouch-anal anastomosis. Functional results are altered almost exclusively during the third trimester, but pouch function promptly returns to prepregnancy status in most females. A small proportion of females have long-term disturbances in function, but these are not related to the method of delivery. Thus, the method of delivery should be dictated by obstetric considerations.
引用
收藏
页码:1283 / 1288
页数:6
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