In this study, researchers from Toronto, Canada, evaluated pregnancy, method of delivery, and functional results in females with chronic ulcerative colitis, who have an ileal pouch-anal anastomosis.
The team sent questionnaires to all women with an ileal pouch-anal anastomosis for chronic ulcerative colitis.
|Only 17% of women suffered a degree of permanent deterioration in pouch function after delivery.
|Diseases of the Colon and Rectum|
They collected information on each pregnancy, method of delivery, and outcome.
Women who had had a successful pregnancy and delivery were contacted by telephone to clarify results and determine pouch functional results.
In addition, clinical information was obtained from the Mount Sinai Hospital Inflammatory Bowel Disease database.
The 38 women in the study had a total of 67 pregnancies, of these, 29 women had 49 deliveries. There were 25 vaginal deliveries and 24 cesarean sections.
The research team found that there were 2 pouch-related complications during the pregnancies and 4 pouch-related complications postpartum. All of these complications were treated nonoperatively.
The team also discovered that stool frequency, and day and night incontinence were increased during pregnancy in most subjects. However, after delivery, prepregnancy function was restored in 83%.
Only 17% of women had some degree of permanent deterioration in pouch function, of these, 3 had vaginal deliveries and 2 had cesarean sections.
Multiple births and birth weight were not found to adversely affect subsequent pouch function.
Dr Ravid's team, from Mount Sinai Hospital, Toronto, concluded that, "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".