Pouch function and gastrointestinal complications during pregnancy after ileal pouch-anal anastomosis

Abstract

Objective. To estimate the risk of gastrointestinal and pouch complications and alterations in pouch function related to pregnancy in women treated with ileal pouch-anal anastomosis (IPAA).

Methods. Pregnancies following IPAA were identified in our center, and in the literature through MEDLINE and PUBMED searches. The incidence of each complication was calculated. Pouch function was compared before and after pregnancy, by mode of delivery, and between women who became pregnant versus those that did not.

Results. The incidence of complications in 283 pregnancies after IPAA was 12.7% including antepartum (2.8%) or postpartum (6.7%) small bowel obstruction, pouchitis (1.8%), and perianal abscess (0.4%). Stool frequency and incontinence were not significantly affected by pregnancy or mode of delivery.

Conclusion. Pregnancy after IPAA is overall safe, associated with limited complications and no significant alteration in pouch function. Vaginal delivery appears as safe as cesarean section for most women.

Keywords:

• ileal pouch-anal anastomosis
• J-pouch
• gastrointestinal complications

Acknowledgements

Figure adapted from McGuire BB. Ileal pouch-anal anastomosis. Br J Surg. 2007;94:812–823.