| 特集名 | クローン病の治療 | |
|---|---|---|
| 題名 | 妊娠時の治療方針 | |
| 発刊年月 | 1998年 01月 | |
| 著者 | 棟方 昭博 | 弘前大学医学部第一内科 |
| 【 要旨 】 | クローン病の好発年齢が妊娠適齢期と重なることから，妊娠・分娩と治療薬剤や疾患の活動性との関連は無視できない問題であり，以下の点について留意する．1) 重症例を除いてクローン病自体は妊娠に影響を及ぼさない． 2) 経腸栄養は妊娠，分娩になんら悪影響を及ぼさず，むしろ栄養の補給という点で優れている． 3) スルファサラジンとステロイドは非妊娠時と同様に妊娠，授乳期ともに用いてよい． 4) 妊娠のクローン病の病勢に及ぼす影響については，妊娠自体よりむしろ妊娠成立時の疾患活動性に依存する． 以上より，患者，医師ともに可能なかぎり緩解期に妊娠するよう心がける． |
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| Theme | Treatment of Crohn's Disease | |
|---|---|---|
| Title | Treatment of Crohn's Disease Associated with Pregnancy | |
| Author | Akihiro Munakata | First Department of Internal Medicine, Hirosaki University School of Medicine |
| [ Summary ] | As Crohn's disease occurs in young people, particularly in the reproductive age group, the influence of Crohn's disease and its treatment on pregnancy should be discussed. From the available data, the effects of Crohn's disease and its therapy on pregnancy can be summarized as follows : 1. Except in severe cases, Crohn's disease does not affect the fetus. 2. Total parenteral nutrition can be used safely to maintain maternal/fetal nutrition and manage disease activity. 3. In the management of Crohn's disease associated with pregnancy, sulfasalazine and/or steroids may be used just as in nonpregnant patients. 4. Safety of maternal immunosuppressant therapy for the fetus and nursing infant is unknown. On the other hand, pregnancy infrequently causes inactive Crohn's disease to flare, and Crohn's disease may be exacerbated during the postpartum period. In conclusion, having Crohn's disease is not a contraindication to pregnancy, and the risk for fetal or maternal complications during pregnancy is more likely to be related to the disease activity than drug therapy. Therefore, patient education and family planning are quite important as well as disease control at the time of conception. |
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