Should I see a high-risk OB if I have ulcerative colitis?

Question

Hello doctor,

I am a 34-year-old woman living with ulcerative colitis, and I am hoping to get pregnant in the near future. I have a few concerns about how this condition might affect my fertility, pregnancy, and the health of the baby.

Could you please explain, in simple terms, whether it is safer to conceive while the disease is in remission?
I would also like to understand if medications such as biologics or steroids are considered safe during pregnancy. In case I experience a flare while pregnant, how is it usually managed?
Lastly, would you recommend consulting a high-risk obstetrician as part of pregnancy planning?

Thank you for your guidance.

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

It is entirely normal to have these fears. The good news is that most women with ulcerative colitis can have healthy pregnancies and newborns, especially if the disease is effectively managed.

In general, it is better to try to conceive while the disorder is in remission. If ulcerative colitis has been stable for several months before pregnancy, fertility rates and pregnancy outcomes are often comparable to those of women without the illness. However, if the condition is active at the time of conception, the chance of problems (such as preterm birth or low birth weight) may be increased.

The majority of maintenance drugs for ulcerative colitis are thought to be safe during pregnancy. In fact, uncontrolled inflammation is often more dangerous than the drugs themselves. Many biologic therapies and medicines, such as mesalamine, can typically be continued. Steroids such as prednisolone may also be used to control a flare during pregnancy, though doctors typically seek to use the lowest effective dose.

If you experience a flare while pregnant, it is usually treated right away using drugs that are considered safe for pregnancy. Effective inflammation management is critical to both the mother's and the baby's health.

Before trying to conceive, see your gastroenterologist about your current medications and illness condition. Many women with inflammatory bowel disease are advised to see a maternal-fetal medicine expert (a high-risk obstetrician) so that the pregnancy can be closely monitored.

Maintaining sustained remission, continuing appropriate meds, using folic acid-fortified prenatal vitamins, and seeing both your gastroenterologist and obstetrician on a regular basis are all beneficial actions. Most women with ulcerative colitis can have safe pregnancies and give birth to healthy babies with proper disease management and coordinated medical care.

I hope this helps.

Thank you.