Skip to main content
Erschienen in: Der Gynäkologe 2/2015

01.02.2015 | Leitthema

Management der chronisch-entzündlichen Darmerkrankungen während der Schwangerschaft

verfasst von: PD Dr. A. Amanzada

Erschienen in: Die Gynäkologie | Ausgabe 2/2015

Einloggen, um Zugang zu erhalten

Zusammenfassung

Hintergrund

Chronisch-entzündliche Darmerkrankungen (CED) betreffen oft Frauen im gebärfähigen Alter. Das therapeutische Management von CED-Patientinnen während einer geplanten oder laufenden Schwangerschaft stellt eine Herausforderung für alle behandelnden Ärzte dar.

Ziel der Arbeit

Darstellung der aktuellen therapeutischen Empfehlungen bei schwangeren CED-Patientinnen mit besonderem Schwerpunkt auf der Durchführung von Magen- und Darmspiegelungen.

Ergebnisse/Diskussion

Eine geplante Konzeption sollte bevorzugt in einer mindestens 3 Monate dauernden klinischen Remission stattfinden. Bei entsprechender Indikation wird empfohlen, eine Magen- oder Darmspiegelung in anästhesiologischer Bereitschaft bevorzugt mit Propofol und Pethidin durchzuführen. Aminosalizylate, Glukokortikoide, Thiopurine und TNF(Tumornekrosefaktor)-α-Inhibitoren gelten als relativ sichere Therapeutika während einer Schwangerschaft und können bei entsprechender Indikation eingesetzt werden. TNF-α-Inhibitoren sollten – falls möglich – vor Beginn des 3. Trimesters pausiert werden.
Literatur
1.
2.
Zurück zum Zitat Anderson CA, Boucher G, Lees CW et al (2011) Meta-analysis identifies 29 additional ulcerative colitis risk loci, increasing the number of confirmed associations to 47. Nat Genet 43:246–252CrossRefPubMedCentralPubMed Anderson CA, Boucher G, Lees CW et al (2011) Meta-analysis identifies 29 additional ulcerative colitis risk loci, increasing the number of confirmed associations to 47. Nat Genet 43:246–252CrossRefPubMedCentralPubMed
3.
Zurück zum Zitat Franke A, McGovern DP, Barrett JC et al (2010) Genome-wide meta-analysis increases to 71 the number of confirmed Crohn’s disease susceptibility loci. Nat Genet 42:1118–1125CrossRefPubMedCentralPubMed Franke A, McGovern DP, Barrett JC et al (2010) Genome-wide meta-analysis increases to 71 the number of confirmed Crohn’s disease susceptibility loci. Nat Genet 42:1118–1125CrossRefPubMedCentralPubMed
4.
Zurück zum Zitat Ponder A, Long MD (2013) A clinical review of recent findings in the epidemiology of inflammatory bowel disease. Clin Epidemiol 5:237–247PubMedCentralPubMed Ponder A, Long MD (2013) A clinical review of recent findings in the epidemiology of inflammatory bowel disease. Clin Epidemiol 5:237–247PubMedCentralPubMed
5.
Zurück zum Zitat Ungaro R, Bernstein CN, Gearry R et al (2014) Antibiotics associated with increased risk of new-onset Crohn’s disease but not ulcerative colitis: a meta-analysis. Am J Gastroenterol 109:1728–1738CrossRefPubMed Ungaro R, Bernstein CN, Gearry R et al (2014) Antibiotics associated with increased risk of new-onset Crohn’s disease but not ulcerative colitis: a meta-analysis. Am J Gastroenterol 109:1728–1738CrossRefPubMed
6.
Zurück zum Zitat Hovde O, Moum BA (2012) Epidemiology and clinical course of Crohn’s disease: results from observational studies. World J Gastroenterol 18:1723–1731CrossRefPubMedCentralPubMed Hovde O, Moum BA (2012) Epidemiology and clinical course of Crohn’s disease: results from observational studies. World J Gastroenterol 18:1723–1731CrossRefPubMedCentralPubMed
7.
Zurück zum Zitat Preiss JC, Bokemeyer B, Buhr HJ et al (2014) Aktualisierte S3-Leitlinie „Diagnostik und Therapie des M. Crohn“. http://www.dgvs.de/fileadmin/user_upload/Leitlinien/Diagnostik-und-Therapie/MC-LL-2014_2014-08-27.pdf Preiss JC, Bokemeyer B, Buhr HJ et al (2014) Aktualisierte S3-Leitlinie „Diagnostik und Therapie des M. Crohn“. http://​www.​dgvs.​de/​fileadmin/​user_​upload/​Leitlinien/​Diagnostik-und-Therapie/​MC-LL-2014_​2014-08-27.​pdf
8.
Zurück zum Zitat Ott C, Obermeier F, Thieler S et al (2008) The incidence of inflammatory bowel disease in a rural region of Southern Germany: a prospective population-based study. Eur J Gastroenterol Hepatol 20:917–923CrossRefPubMed Ott C, Obermeier F, Thieler S et al (2008) The incidence of inflammatory bowel disease in a rural region of Southern Germany: a prospective population-based study. Eur J Gastroenterol Hepatol 20:917–923CrossRefPubMed
9.
Zurück zum Zitat Molodecky NA, Soon IS, Rabi DM et al (2012) Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology 142:46–54CrossRefPubMed Molodecky NA, Soon IS, Rabi DM et al (2012) Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology 142:46–54CrossRefPubMed
10.
Zurück zum Zitat Loftus CG, Loftus EV Jr, Harmsen WS et al (2007) Update on the incidence and prevalence of Crohn’s disease and ulcerative colitis in Olmsted County, Minnesota, 1940–2000. Inflamm Bowel Dis 13:254–261CrossRefPubMed Loftus CG, Loftus EV Jr, Harmsen WS et al (2007) Update on the incidence and prevalence of Crohn’s disease and ulcerative colitis in Olmsted County, Minnesota, 1940–2000. Inflamm Bowel Dis 13:254–261CrossRefPubMed
11.
Zurück zum Zitat Dignass A, Preiss JC, Aust DE et al (2011) Updated German guideline on diagnosis and treatment of ulcerative colitis, 2011. Z Gastroenterol 49:1276–1341CrossRefPubMed Dignass A, Preiss JC, Aust DE et al (2011) Updated German guideline on diagnosis and treatment of ulcerative colitis, 2011. Z Gastroenterol 49:1276–1341CrossRefPubMed
12.
Zurück zum Zitat Timmer A, Goebell H (1999) Incidence of ulcerative colitis, 1980–1995 – a prospective study in an urban population in Germany. Z Gastroenterol 37:1079–1084PubMed Timmer A, Goebell H (1999) Incidence of ulcerative colitis, 1980–1995 – a prospective study in an urban population in Germany. Z Gastroenterol 37:1079–1084PubMed
13.
Zurück zum Zitat Loftus EV Jr (2004) Clinical epidemiology of inflammatory bowel disease: incidence, prevalence, and environmental influences. Gastroenterology 126:1504–1517CrossRefPubMed Loftus EV Jr (2004) Clinical epidemiology of inflammatory bowel disease: incidence, prevalence, and environmental influences. Gastroenterology 126:1504–1517CrossRefPubMed
14.
Zurück zum Zitat Lowe AM, Roy PO, Poulin M et al (2009) Epidemiology of Crohn’s disease in Quebec, Canada. Inflamm Bowel Dis 15:429–435CrossRefPubMed Lowe AM, Roy PO, Poulin M et al (2009) Epidemiology of Crohn’s disease in Quebec, Canada. Inflamm Bowel Dis 15:429–435CrossRefPubMed
15.
Zurück zum Zitat Vind I, Riis L, Jess T et al (2006) Increasing incidences of inflammatory bowel disease and decreasing surgery rates in Copenhagen City and County, 2003–2005: a population-based study from the Danish Crohn colitis database. Am J Gastroenterol 101:1274–1282CrossRefPubMed Vind I, Riis L, Jess T et al (2006) Increasing incidences of inflammatory bowel disease and decreasing surgery rates in Copenhagen City and County, 2003–2005: a population-based study from the Danish Crohn colitis database. Am J Gastroenterol 101:1274–1282CrossRefPubMed
16.
Zurück zum Zitat Zhou P, Luo X, Qi HB et al (2012) The expression of pentraxin 3 and tumor necrosis factor-alpha is increased in preeclamptic placental tissue and maternal serum. Inflamm Res 61:1005–1012CrossRefPubMed Zhou P, Luo X, Qi HB et al (2012) The expression of pentraxin 3 and tumor necrosis factor-alpha is increased in preeclamptic placental tissue and maternal serum. Inflamm Res 61:1005–1012CrossRefPubMed
17.
Zurück zum Zitat Baird DD, Narendranathan M, Sandler RS (1990) Increased risk of preterm birth for women with inflammatory bowel disease. Gastroenterology 99:987–994PubMed Baird DD, Narendranathan M, Sandler RS (1990) Increased risk of preterm birth for women with inflammatory bowel disease. Gastroenterology 99:987–994PubMed
19.
Zurück zum Zitat Woolfson K, Cohen Z, McLeod RS (1990) Crohn’s disease and pregnancy. Dis Colon Rectum 33:869–873CrossRefPubMed Woolfson K, Cohen Z, McLeod RS (1990) Crohn’s disease and pregnancy. Dis Colon Rectum 33:869–873CrossRefPubMed
20.
Zurück zum Zitat Fonager K, Sorensen HT, Olsen J et al (1998) Pregnancy outcome for women with Crohn’s disease: a follow-up study based on linkage between national registries. Am J Gastroenterol 93:2426–2430CrossRefPubMed Fonager K, Sorensen HT, Olsen J et al (1998) Pregnancy outcome for women with Crohn’s disease: a follow-up study based on linkage between national registries. Am J Gastroenterol 93:2426–2430CrossRefPubMed
21.
Zurück zum Zitat Baiocco PJ, Korelitz BI (1984) The influence of inflammatory bowel disease and its treatment on pregnancy and fetal outcome. J Clin Gastroenterol 6:211–216PubMed Baiocco PJ, Korelitz BI (1984) The influence of inflammatory bowel disease and its treatment on pregnancy and fetal outcome. J Clin Gastroenterol 6:211–216PubMed
22.
Zurück zum Zitat Hanan IM, Kirsner JB (1985) Inflammatory bowel disease in the pregnant woman. Clin Perinatol 12:669–682PubMed Hanan IM, Kirsner JB (1985) Inflammatory bowel disease in the pregnant woman. Clin Perinatol 12:669–682PubMed
23.
Zurück zum Zitat Selinger CP, Eaden J, Selby W et al (2013) Inflammatory bowel disease and pregnancy: lack of knowledge is associated with negative views. J Crohns Colitis 7:e206–e213CrossRefPubMed Selinger CP, Eaden J, Selby W et al (2013) Inflammatory bowel disease and pregnancy: lack of knowledge is associated with negative views. J Crohns Colitis 7:e206–e213CrossRefPubMed
24.
Zurück zum Zitat Mahadevan U, Sandborn WJ, Li DK et al (2007) Pregnancy outcomes in women with inflammatory bowel disease: a large community-based study from Northern California. Gastroenterology 133:1106–1112CrossRefPubMed Mahadevan U, Sandborn WJ, Li DK et al (2007) Pregnancy outcomes in women with inflammatory bowel disease: a large community-based study from Northern California. Gastroenterology 133:1106–1112CrossRefPubMed
25.
Zurück zum Zitat Mogadam M, Korelitz BI, Ahmed SW et al (1981) The course of inflammatory bowel disease during pregnancy and postpartum. Am J Gastroenterol 75:265–269PubMed Mogadam M, Korelitz BI, Ahmed SW et al (1981) The course of inflammatory bowel disease during pregnancy and postpartum. Am J Gastroenterol 75:265–269PubMed
27.
Zurück zum Zitat Siegmund B, Zeitz M (2009) Inflammatory bowel disease and pregnancy. Z Gastroenterol 47:1069–1074CrossRefPubMed Siegmund B, Zeitz M (2009) Inflammatory bowel disease and pregnancy. Z Gastroenterol 47:1069–1074CrossRefPubMed
28.
Zurück zum Zitat Akbari M, Shah S, Velayos FS et al (2013) Systematic review and meta-analysis on the effects of thiopurines on birth outcomes from female and male patients with inflammatory bowel disease. Inflamm Bowel Dis 19:15–22CrossRefPubMed Akbari M, Shah S, Velayos FS et al (2013) Systematic review and meta-analysis on the effects of thiopurines on birth outcomes from female and male patients with inflammatory bowel disease. Inflamm Bowel Dis 19:15–22CrossRefPubMed
30.
Zurück zum Zitat Nguyen GC, Boudreau H, Harris ML, Maxwell CV (2009) Outcomes of obstetric hospitalizations among women with inflammatory bowel disease in the United States. Clin Gastroenterol Hepatol 7:329–334CrossRefPubMed Nguyen GC, Boudreau H, Harris ML, Maxwell CV (2009) Outcomes of obstetric hospitalizations among women with inflammatory bowel disease in the United States. Clin Gastroenterol Hepatol 7:329–334CrossRefPubMed
31.
Zurück zum Zitat Riis L, Vind I, Politi P et al (2006) Does pregnancy change the disease course? A study in a European cohort of patients with inflammatory bowel disease. Am J Gastroenterol 101:1539–1545CrossRefPubMed Riis L, Vind I, Politi P et al (2006) Does pregnancy change the disease course? A study in a European cohort of patients with inflammatory bowel disease. Am J Gastroenterol 101:1539–1545CrossRefPubMed
32.
Zurück zum Zitat Solem CA, Loftus EV Jr, Tremaine WJ et al (2005) Correlation of C-reactive protein with clinical, endoscopic, histologic, and radiographic activity in inflammatory bowel disease. Inflamm Bowel Dis 11:707–712CrossRefPubMed Solem CA, Loftus EV Jr, Tremaine WJ et al (2005) Correlation of C-reactive protein with clinical, endoscopic, histologic, and radiographic activity in inflammatory bowel disease. Inflamm Bowel Dis 11:707–712CrossRefPubMed
33.
Zurück zum Zitat Schoepfer AM, Beglinger C, Straumann A et al (2010) Fecal calprotectin correlates more closely with the Simple Endoscopic Score for Crohn’s disease (SES-CD) than CRP, blood leukocytes, and the CDAI. Am J Gastroenterol 105:162–169CrossRefPubMed Schoepfer AM, Beglinger C, Straumann A et al (2010) Fecal calprotectin correlates more closely with the Simple Endoscopic Score for Crohn’s disease (SES-CD) than CRP, blood leukocytes, and the CDAI. Am J Gastroenterol 105:162–169CrossRefPubMed
34.
Zurück zum Zitat Boirivant M, Leoni M, Tariciotti D et al (1988) The clinical significance of serum C reactive protein levels in Crohn’s disease. Results of a prospective longitudinal study. J Clin Gastroenterol 10:401–405CrossRefPubMed Boirivant M, Leoni M, Tariciotti D et al (1988) The clinical significance of serum C reactive protein levels in Crohn’s disease. Results of a prospective longitudinal study. J Clin Gastroenterol 10:401–405CrossRefPubMed
35.
Zurück zum Zitat Migaleddu V, Scanu AM, Quaia E et al (2009) Contrast-enhanced ultrasonographic evaluation of inflammatory activity in Crohn’s disease. Gastroenterology 137:43–52CrossRefPubMed Migaleddu V, Scanu AM, Quaia E et al (2009) Contrast-enhanced ultrasonographic evaluation of inflammatory activity in Crohn’s disease. Gastroenterology 137:43–52CrossRefPubMed
36.
Zurück zum Zitat Pallotta N, Vincoli G, Montesani C et al (2012) Small intestine contrast ultrasonography (SICUS) for the detection of small bowel complications in crohn’s disease: a prospective comparative study versus intraoperative findings. Inflamm Bowel Dis 18:74–84CrossRefPubMed Pallotta N, Vincoli G, Montesani C et al (2012) Small intestine contrast ultrasonography (SICUS) for the detection of small bowel complications in crohn’s disease: a prospective comparative study versus intraoperative findings. Inflamm Bowel Dis 18:74–84CrossRefPubMed
37.
Zurück zum Zitat Woude CJ van der, Kolacek S, Dotan I et al (2010) European evidenced-based consensus on reproduction in inflammatory bowel disease. J Crohns Colitis 4:493–510CrossRefPubMed Woude CJ van der, Kolacek S, Dotan I et al (2010) European evidenced-based consensus on reproduction in inflammatory bowel disease. J Crohns Colitis 4:493–510CrossRefPubMed
38.
Zurück zum Zitat Cury DB, Moss AC (2014) Treatment of Crohn’s disease in pregnant women: drug and multidisciplinary approaches. World J Gastroenterol 20:8790–8795PubMedCentralPubMed Cury DB, Moss AC (2014) Treatment of Crohn’s disease in pregnant women: drug and multidisciplinary approaches. World J Gastroenterol 20:8790–8795PubMedCentralPubMed
39.
Zurück zum Zitat Cappell MS (2003) The fetal safety and clinical efficacy of gastrointestinal endoscopy during pregnancy. Gastroenterol Clin North Am 32:123–179CrossRefPubMed Cappell MS (2003) The fetal safety and clinical efficacy of gastrointestinal endoscopy during pregnancy. Gastroenterol Clin North Am 32:123–179CrossRefPubMed
40.
Zurück zum Zitat Gilinsky NH, Muthunayagam N (2006) Gastrointestinal endoscopy in pregnant and lactating women: emerging standard of care to guide decision-making. Obstet Gynecol Surv 61:791–799CrossRefPubMed Gilinsky NH, Muthunayagam N (2006) Gastrointestinal endoscopy in pregnant and lactating women: emerging standard of care to guide decision-making. Obstet Gynecol Surv 61:791–799CrossRefPubMed
41.
Zurück zum Zitat Quan WL, Chia CK, Yim HB (2006) Safety of endoscopical procedures during pregnancy. Singapore Med J 47:525–528PubMed Quan WL, Chia CK, Yim HB (2006) Safety of endoscopical procedures during pregnancy. Singapore Med J 47:525–528PubMed
42.
43.
Zurück zum Zitat Norgard B, Czeizel AE, Rockenbauer M et al (2001) Population-based case control study of the safety of sulfasalazine use during pregnancy. Aliment Pharmacol Ther 15:483–486CrossRefPubMed Norgard B, Czeizel AE, Rockenbauer M et al (2001) Population-based case control study of the safety of sulfasalazine use during pregnancy. Aliment Pharmacol Ther 15:483–486CrossRefPubMed
44.
Zurück zum Zitat Rahimi R, Nikfar S, Rezaie A, Abdollahi M (2008) Pregnancy outcome in women with inflammatory bowel disease following exposure to 5-aminosalicylic acid drugs: a meta-analysis. Reprod Toxicol 25:271–275CrossRefPubMed Rahimi R, Nikfar S, Rezaie A, Abdollahi M (2008) Pregnancy outcome in women with inflammatory bowel disease following exposure to 5-aminosalicylic acid drugs: a meta-analysis. Reprod Toxicol 25:271–275CrossRefPubMed
45.
Zurück zum Zitat Moffatt DC, Bernstein CN (2007) Drug therapy for inflammatory bowel disease in pregnancy and the puerperium. Best Pract Res Clin Gastroenterol 21:835–847CrossRefPubMed Moffatt DC, Bernstein CN (2007) Drug therapy for inflammatory bowel disease in pregnancy and the puerperium. Best Pract Res Clin Gastroenterol 21:835–847CrossRefPubMed
46.
Zurück zum Zitat Carmichael SL, Shaw GM, Ma C et al (2007) Maternal corticosteroid use and orofacial clefts. Am J Obstet Gynecol 197:585–587PubMed Carmichael SL, Shaw GM, Ma C et al (2007) Maternal corticosteroid use and orofacial clefts. Am J Obstet Gynecol 197:585–587PubMed
47.
Zurück zum Zitat Beaulieu DB, Ananthakrishnan AN, Issa M et al (2009) Budesonide induction and maintenance therapy for Crohn’s disease during pregnancy. Inflamm Bowel Dis 15:25–28CrossRefPubMed Beaulieu DB, Ananthakrishnan AN, Issa M et al (2009) Budesonide induction and maintenance therapy for Crohn’s disease during pregnancy. Inflamm Bowel Dis 15:25–28CrossRefPubMed
48.
Zurück zum Zitat Boer NK de, Jarbandhan SV, Graaf P de et al (2006) Azathioprine use during pregnancy: unexpected intrauterine exposure to metabolites. Am J Gastroenterol 101:1390–1392CrossRefPubMed Boer NK de, Jarbandhan SV, Graaf P de et al (2006) Azathioprine use during pregnancy: unexpected intrauterine exposure to metabolites. Am J Gastroenterol 101:1390–1392CrossRefPubMed
49.
Zurück zum Zitat Cleary BJ, Kallen B (2009) Early pregnancy azathioprine use and pregnancy outcomes. Birth Defects Res A Clin Mol Teratol 85:647–654CrossRefPubMed Cleary BJ, Kallen B (2009) Early pregnancy azathioprine use and pregnancy outcomes. Birth Defects Res A Clin Mol Teratol 85:647–654CrossRefPubMed
50.
Zurück zum Zitat Goldstein LH, Dolinsky G, Greenberg R et al (2007) Pregnancy outcome of women exposed to azathioprine during pregnancy. Birth Defects Res A Clin Mol Teratol 79:696–701CrossRefPubMed Goldstein LH, Dolinsky G, Greenberg R et al (2007) Pregnancy outcome of women exposed to azathioprine during pregnancy. Birth Defects Res A Clin Mol Teratol 79:696–701CrossRefPubMed
51.
Zurück zum Zitat Broms G, Granath F, Linder M et al (2014) Birth outcomes in women with inflammatory bowel disease: effects of disease activity and drug exposure. Inflamm Bowel Dis 20:1091–1098PubMed Broms G, Granath F, Linder M et al (2014) Birth outcomes in women with inflammatory bowel disease: effects of disease activity and drug exposure. Inflamm Bowel Dis 20:1091–1098PubMed
52.
Zurück zum Zitat Langagergaard V, Pedersen L, Gislum M et al (2007) Birth outcome in women treated with azathioprine or mercaptopurine during pregnancy: a Danish nationwide cohort study. Aliment Pharmacol Ther 25:73–81CrossRefPubMed Langagergaard V, Pedersen L, Gislum M et al (2007) Birth outcome in women treated with azathioprine or mercaptopurine during pregnancy: a Danish nationwide cohort study. Aliment Pharmacol Ther 25:73–81CrossRefPubMed
53.
Zurück zum Zitat Kane SV, Acquah LA (2009) Placental transport of immunoglobulins: a clinical review for gastroenterologists who prescribe therapeutic monoclonal antibodies to women during conception and pregnancy. Am J Gastroenterol 104:228–233CrossRefPubMed Kane SV, Acquah LA (2009) Placental transport of immunoglobulins: a clinical review for gastroenterologists who prescribe therapeutic monoclonal antibodies to women during conception and pregnancy. Am J Gastroenterol 104:228–233CrossRefPubMed
54.
Zurück zum Zitat Narula N, Al-Dabbagh R, Dhillon A et al (2014) Anti-TNFalpha therapies are safe during pregnancy in women with inflammatory bowel disease: a systematic review and meta-analysis. Inflamm Bowel Dis 20:1862–1869CrossRefPubMed Narula N, Al-Dabbagh R, Dhillon A et al (2014) Anti-TNFalpha therapies are safe during pregnancy in women with inflammatory bowel disease: a systematic review and meta-analysis. Inflamm Bowel Dis 20:1862–1869CrossRefPubMed
55.
Zurück zum Zitat Deepak P, Stobaugh DJ (2014) Maternal and foetal adverse events with tumour necrosis factor-alpha inhibitors in inflammatory bowel disease. Aliment Pharmacol Ther 40:1035–1043CrossRefPubMed Deepak P, Stobaugh DJ (2014) Maternal and foetal adverse events with tumour necrosis factor-alpha inhibitors in inflammatory bowel disease. Aliment Pharmacol Ther 40:1035–1043CrossRefPubMed
56.
Zurück zum Zitat Piper JM, Mitchel EF, Ray WA (1993) Prenatal use of metronidazole and birth defects: no association. Obstet Gynecol 82:348–352PubMed Piper JM, Mitchel EF, Ray WA (1993) Prenatal use of metronidazole and birth defects: no association. Obstet Gynecol 82:348–352PubMed
57.
Zurück zum Zitat Berkovitch M, Pastuszak A, Gazarian M et al (1994) Safety of the new quinolones in pregnancy. Obstet Gynecol 84:535–538PubMed Berkovitch M, Pastuszak A, Gazarian M et al (1994) Safety of the new quinolones in pregnancy. Obstet Gynecol 84:535–538PubMed
58.
Zurück zum Zitat Hatch Q, Champagne BJ, Maykel JA et al (2014) The impact of pregnancy on surgical Crohn disease: an analysis of the Nationwide Inpatient Sample. J Surg Res 190:41–46CrossRefPubMed Hatch Q, Champagne BJ, Maykel JA et al (2014) The impact of pregnancy on surgical Crohn disease: an analysis of the Nationwide Inpatient Sample. J Surg Res 190:41–46CrossRefPubMed
59.
Zurück zum Zitat Visser BC, Glasgow RE, Mulvihill KK, Mulvihill SJ (2001) Safety and timing of nonobstetric abdominal surgery in pregnancy. Dig Surg 18:409–417CrossRefPubMed Visser BC, Glasgow RE, Mulvihill KK, Mulvihill SJ (2001) Safety and timing of nonobstetric abdominal surgery in pregnancy. Dig Surg 18:409–417CrossRefPubMed
Metadaten
Titel
Management der chronisch-entzündlichen Darmerkrankungen während der Schwangerschaft
verfasst von
PD Dr. A. Amanzada
Publikationsdatum
01.02.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Die Gynäkologie / Ausgabe 2/2015
Print ISSN: 2731-7102
Elektronische ISSN: 2731-7110
DOI
https://doi.org/10.1007/s00129-014-3409-x

Weitere Artikel der Ausgabe 2/2015

Der Gynäkologe 2/2015 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.