臨床婦人科産科75巻12号

2021年12月発行

今月の臨床 プレコンセプションケアにどう取り組むか―いつ，誰に，何をする？ プレコンセプションケアの実際 : 基礎疾患のある患者への家族計画・妊娠前指導

炎症性腸疾患

著者： 渡辺知佳子¹

所属機関： ¹国際医療福祉大学三田病院消化器センター

ページ範囲：P.1206 - P.1211

●炎症性腸疾患患者は，非活動期に妊娠成立すれば，妊娠中の再燃リスクも低く，健常妊娠とほぼ同等の妊娠転帰を得ることができる．

●活動性コントロールのために，IBD治療薬は基本的にすべて妊娠中も継続する．アドヒアランスの低下は活動性増悪のリスク因子であり，妊娠計画時の服薬指導は大切である．

●IBDの活動性がコントロールされていれば，妊孕性は健常人とほぼ同等だが，手術歴などから妊孕性の低下が考えられる場合は，体外受精や顕微授精を早めに考慮する．妊娠までに時間がかかる例もあるので，妊娠計画は早めに進める．

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