Upalne bolesti crijeva i trudnoća

master's thesis

• Title (english): Inflammatory bowel disease and pregnacy
• Author: Dora Moćan
• Mentor: Marko Duvnjak (mentor)
• Committee member: Lucija Virović Jukić (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Marko Duvnjak (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Upalne bolesti crijeva su skupina bolesti koja obuhvaća Crohnovu bolest i ulcerozni kolitis. Ukupna prevalencija tih bolesti procjenjuje se na 369/100.000 osoba te su jedne od najčešćih kroničnih upalnih bolesti. Incidencija je najviša između 15. i 30. godine života, upravo među mladim ljudima fertilne dobi. Ove bolesti odlikuje nepredvidljiv tijek i potreba za doživotnom terapijom. Etiologija bolesti nije u potpunosti poznata, ali zna se da osim nasljeđa veliku ulogu imaju i još nedovoljno istraženi vanjski čimbenici. Žene koje boluju od upalnih bolesti crijeva često se ne odlučuju na trudnoću zbog straha od neplodnosti, mogućeg štetnog učinka terapije na plod te nasljednosti bolesti. Plodnost ovih pacijentica se u pravilu ne razlikuje od opće populacije, osobito u mirnoj fazi bolesti. Tijek bolesti u trudnoći uvelike ovisi o aktivnosti bolesti u vrijeme začeća, tako da će aktivna bolest češće perzistirati ili se pogoršati u tijeku trudnoće. Važno je planirati trudnoću. Upalne bolesti crijeva najčešće nisu kontraindikacija za vaginalni porod. Dugoročno, trudnoća može imati protektivan učinak na tijek bolesti. Uočena je niža incidencija relapsa i kirurških zahvata u bolesnica koje su rodile. U nekim slučajevima potrebno je koristiti endoskopske i radiološke pretrage kod trudnih bolesnica, a u najtežim slučajevima i kirurški zahvat. Sve pretrage moraju biti strogo indicirane, a po mogućnosti se biraju one s manjim rizikom. Od lijekova koji se koriste za liječenje upalnih bolesti crijeva, mnogi su sigurni za korištenje tijekom trudnoće i dojenja te je omogućena trajna kontrola bolesti s minimalnim rizikom za dijete.

Abstract (english)

Inflammatory bowel disease is a group of diseases which includes Crohn's disease and ulcerative colitis. Total prevalence of the disease is estimated to be 369/100.000 people and is one of the most common chronic inflammatory diseases. Its incidence peaks between the age of 15 and 30, among young fertile people. The course of the disease is unpredictable and it requires a lifelong therapy. Etiology is not yet well known, but aside from the heritage, many still unknown environmental factors play an important role. Women suffering from this disease often decide not to have children because of the fear of infertility, possible negative effect of drugs on the child and the heritage. The fertility of these patients does not differ significantly from the general population, especially in the quiet phase of the disease. The course of the disease during pregnancy depends on the activity of the disease during the conception, so active disease will persist or get worse. Planning pregnancy is important. Inflammatory bowel disease, in most cases, does not represent a contraindication for vaginal birth. On the long term, pregnancy can have beneficial influence on its course. There is a lower incidence of relapses and surgical procedures in women whit inflammatory bowel disease who have given birth. In some cases, endoscopic, radiologic or surgical procedures are required during pregnancy. If it is possible, the ones with lower risk are preferred. Many of the drugs used to treat inflammatory bowel disease are proven to be safe during pregnancy and lactation, so the permanent control of the disease is possible with minimal risks to the child.

• Keywords: upalne bolesti crijeva; Crohnova bolest; ulcerozni kolitis; trudnoća; dojenje
• Keywords (english): inflammatory bowel disease; Crohn's disease; ulcerative colitis; pregnancy; lactation
• Language: croatian
• URN:NBN: urn:nbn:hr:105:053920
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-10-28 13:04:29