Two weeks later, she does not respond to 4.8g of mesalamine, has negative c. dificile, quantiferon and hepatitis serologies and an unprepped unsedated flex sig now shows Mayo subscore 2 disease.
Which of the following would you recommend?
Start infliximab, vedolizumab or ustekinumab and, if effective, continue throughout pregnancy and lactation
Refrain from starting biologic during pregnancy and lactation period
All current biologics approved for Crohn’s disease and UC are appropriate for use throughout pregnancy and lactation
Regardless of disease state, delivery should be via cesarean section.
If a patient is in remission, mode of delivery is per OB and can be vaginal
Start infliximab, vedolizumab or ustekinumab and stop at week 22 of gestation.
Continuing biologics through pregnancy has not been associated with harm, but stopping early may lead to flares which do increase maternal and neonatal complications.
Click here to the move on to the discussion
Click here to return to the prior part