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Gastroenterologie up2date 2024; 20(04): 405-420
DOI: 10.1055/a-2061-0701
Darm/Anorektum

Schwangerschaft und Stillen mit chronisch-entzündlichen Darmerkrankungen

Niels Teich 
,
Andreas Stallmach 
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Kinderwunsch bei einer chronisch entzündlichen Darmerkrankung (CED) ruft bei Betroffenen oft große Unsicherheit hervor. Unsere Übersicht bietet Argumentationshilfen für das Gespräch mit CED-Erkrankten und ihren Partnerinnen und Partnern und beantwortet häufig gestellte Fragen zur medikamentösen Therapie während der Schwangerschaft. Dabei konzentrieren wir uns auf Aspekte, deren Bewertung in den letzten Jahren einen Wandel erfahren hat.
Kernaussagen

  • Eine stabile steroidfreie Remission der CED ist ein günstiger Zeitraum für eine erfolgreiche Konzeption und einen günstigen Schwangerschaftsverlauf.

  • CED-Patientinnen mit Kinderwunsch sollten nicht rauchen.

  • Der Schwangerschaftsverlauf bei Patientinnen mit chronisch entzündlichen Darmerkrankungen ist meist unkompliziert.

  • Die remissionserhaltende Therapie sollte unter Beachtung weniger Kontraindikationen in der Schwangerschaft und postpartal beibehalten werden.

  • MTX sollte bei CED-Patientinnen mit Kinderwunsch nicht eingesetzt werden.

  • Systemische Kortikosteroide sollten in der Schwangerschaft möglichst gemieden oder höchstens kurzzeitig und niedrig dosiert verabreicht werden.

  • TNF-Antikörper sind auch in der Schwangerschaft und Stillzeit eine sichere Therapie.

  • Stillen ist CED-Patientinnen in fast jeder Situation möglich.

Schlüsselwörter

Morbus Crohn - Colitis ulcerosa - Schwangerschaft - Stillzeit - Immunsuppression - Biologika


Publication History

Article published online:
11 December 2024

© 2024. Thieme. All rights reserved.

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