Thread by @john_damianosMD

Very important and high-yield #AIBD2020 session with @UmaMahadevanIBD on #IBD in #pregnancy! 🤰🔥💩👶
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@IBDConference #GITwitter #GI #OBGYNtwitter #OBGYN

Management of a healthy pregnancy begins... before pregnancy!

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

Start planning early!

Want 3 months of steroid-free remission before conception.

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

Best contraception in #IBD is progesterone-based LARCs.

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

#IBD patients should take low-dose #aspirin to prevent #preeclampsia if #OBGYN recommends.

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

Pregnant #IBD patients (and any pregnant patients) should AVOID #cannabis.

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

Pregnant #IBD patients should be extra cautious with respect to #COVID19.

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

Congrats on the #pregnancy! Now what?! Manage the disease!

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

Control of disease is key in preventing adverse #pregnancy outcomes!

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

Managing flares is similar to in non-pregnant patients. Avoid MTX and tofacitinib.

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

Steroids should NOT be used as maintenance, as they are associated with poor maternal and fetal outcomes.

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

Summary of #PIANO! (See prior thread for more detail!)

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

Other data sets confirm #PIANO showing safety of anti-TNFs in #pregnancy.

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

However removing TNF therapy increases maternal disease risks...

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

Try to avoid TOFA, especially in 1st trimester.

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

Delivery? Leave it to the #OBGYN! But some things to consider...

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

Postpartum!

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

Breastfeeding is safe while on #IBD medications! No need to avoid, or to pump-n-dump.

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

Exposure to biologics does not impact vaccine response.

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

Kids tend to do very very well!

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD