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 22 May 2018

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News

Pregnancy and delivery before and after ileal pouch-anal anastomosis

Successful pregnancy and vaginal delivery occurs routinely in women with chronic ulcerative colitis both before and after ileal pouch-anal anastomosis, find doctors in the July issue of Diseases of the Colon and Rectum.

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In this study, doctors from Switzerland and the United States evaluated pregnancy, delivery, and functional outcome before and after ileal pouch-anal anastomosis.

They assessed 1454 patients who underwent ileal pouch-anal anastomosis for chronic ulcerative colitis between 1981 and 1995.

The team sent a standardized questionnaire was sent to all female patients aged 40 years or younger at the time of ileal pouch-anal anastomosis (n = 544).

The response rate was 83%. There was a mean follow-up after ileal pouch-anal anastomosis of 13 years.

The doctors found that 141 females were pregnant after the chronic ulcerative colitis diagnosis, but before ileal pouch-anal anastomosis.

They also found that 135 women were pregnant after ileal pouch-anal anastomosis.

The team compared pregnancy and delivery both before and after ileal pouch-anal anastomosis in 37 women. They found no difference in birth weight, duration of labor, pregnancy/delivery complications, vaginal delivery rates, or unplanned cesarean section.

They determined that pouch function at first follow-up after delivery was similar to pregravida function.
Pouch function after delivery was similar to pregravida function.
Diseases of the Colon and Rectum

After ileal pouch-anal anastomosis, daytime stool frequency was the same after delivery as pregravida but increased at the time of last follow-up.

The doctors found that the rate of occasional fecal incontinence also was higher.

However, they found no difference in functional outcome when women who were pregnant were compared with women who were never pregnant after ileal pouch-anal anastomosis.

Dr Dieter Hahnloser and colleagues concluded, "Successful pregnancy and vaginal delivery occur routinely in females with chronic ulcerative colitis before and after ileal pouch-anal anastomosis".

"The method of delivery should be dictated by obstetrical considerations".

"Pouch function and the incidence of complications in females with pregnancies seem largely unaffected long-term".

Dis Colon Rectum 2004; 47(7): 1127-35
25 June 2004

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