Maladies inflammatoires chroniques de l'intestin et grossesse

Inflammatory bowel disease (IBD) frequently affects young adults and physicians are often presented with their patients concerns about the effects of IBD on pregnancy. With good control of the activity of IBD, this patients have the same chance to conceive as someone without IBD. If ulcerative colitis or Crohn's disease is inactive at the time of conception, the relapse rate during pregnancy and in the postpartum period is similar to the 1-year relapse rate in nonpregnant patients. Active IBD during pregnancy is associated with an increase in preterm delivery, spontaneous abortions and stillbirths. Sulfasalazine, mesalazine and corticosteroids can be used safely to maitain or induce remission during pregnancy. Increased experience with 6-mercaptopurine (6-MP) and azathioprine during pregnancy seems to indicate their relative safety regarding the course of pregnancy and incidence of congenital abnormalities. Others immunosuppressive drugs are not allowed during pregnancy. In conclusion, the physician caring for the patient with IBD can be quite optimistic regardind the ability of the IBD patients to conceive. Close supervision by both gastroenterologist and obstetrician in most instances will yield a safe outcome for mother and baby.