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Crohns and Colitis UKpregnancytalknov13ppt 克罗恩病和溃疡性结肠炎的英国课件
Talk outline Can I have children? YES Why talk about it then? Not everyone knows this Patients Doctors Friends relatives It should involve careful planning Can I pass IBD on to my child? Developing IBD is complex Family history / Inherited part / Genes Environmental effects Smoking “Dirt exposure” Antibiotics in childhood Many unknown as yet Who gave birth after being diagnosed with IBD? Can I pass IBD on to my child? Chance of passing on IBD If one parent affected: 4-10% If both parents affected: 30% Very good chance child will not get IBD Whether you child will get IBD depends on many other factors Fertility In men Normal Sulphasalazine can temporarily disturb it In women Generally good Better chance of falling pregnant When well Good disease control Fertility Vast majority should experience little problems (other than the general public) Problem areas Crohn’s disease with complex inflammation in pelvis / “deep” pelvic surgery Pouch surgery IVF works in these cases Anyone experienced fertility problems? Fertility Unable to have children “involuntary infertility” Overall not more common than general public Decided not to have children “voluntary infertility” Much more common in IBD 18% versus 6% in general public Decided not to have children Why? Might not be aware that they can Poor knowledge Anxiety about pregnancy, inheritance Bad advice “Google”… Friends Some doctors not well informed We need to get the message out When to have a baby? When well / in remission Better chance of falling pregnant Better chance of good course of pregnancy In some cases this might mean Increased medication Decisions around surgery If What operation when Medication and Pregnancy Worth talking about Active disease (ongoing symptoms) Less chance of conceiving Worse outcomes for the baby Premature birth Small baby Loss of pregnancy Hence need to keep disease under control Medication and Pregnancy Who stopped medication?Who continued? Medication and Pregnancy Generally bene
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