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    1. North-Western State Medical University n. a. I. I. Mechnikov (St. Petersburg, Russian Federation)

    Keywords:inflammatory bowel diseases (IBD),ulcerative colitis (UC),Crohn’s disease (CD),pharmacotherapy of IBD in pregnancy

    Abstract:Inflammatory bowel diseases (IBD) are an actual problem of reproductive medicine, and the care of women in childbearing age suffering from IBD has a high medical and social significance. The main peak of incidence of IBD falls on the age of 20-40 years, when childbirth is planned. Questions that need to be addressed and discussed in patients with IBD: is it possible for the normal course of pregnancy with IBD, how does the IBD affect pregnancy, what medications are contraindicated and others. The article presents and discusses theoretical aspects and practical issues related to pregnancy management, IBD therapy in the period of preparation to pregnancy, during pregnancy, in the postpartum period, the effectiveness and safety of pharmacotherapy in patients of this category is discussed.

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      2. Бакулин И. Г. Индексы активности - объективные критерии оценки степени тяжести язвенного колита / Бакулин И. Г. Станке Д. А., Белоусова Е. А., Головенко О. В., Михайлова Т. Л. // Экспериментальная и клинич. гастроэнтерология. - 2008. - № 6. - С. 14-16.
      3. Регистр воспалительных заболеваний кишечника в г. Новосибирске: итоги 2016 / Осипенко М. Ф., Валуйских Е. Ю., Светлова И. О., Кулыгина Ю. А., Скалинская М. И., Бикбулатова Е. А., Краснер Я. А. // Сибирский научный медицинский журнал. 2017. Т. 37. № 1. С. 61-67.
      4. D. Simian, D. Fluxá, L. Flores, J. Lubascher, P. Ibáñez, C. et al. Inflammatory bowel disease: A descriptive study of 716 local Chilean patients. World J Gastroenterol. 2016 June 14, 22 (22), С. 5267-5275.
      5. The Second European Evidenced-Based Consensus on Reproduction and Pregnancy in Inflammatory Bowel Disease C. J. van der Woude, C.J. van der Woude Corresponding author: C. Janneke van der Woude, Erasmus MC, Department of Gastroenterology and Hepatology, for the European Crohn’s and Colitis Organization (ECCO) / for the European Crohn’s and Colitis Organization (ECCO)/Published: 16 January 2015.
      6. Third European Evidence-Based Consensus on Diagnosis and Management of Ulcerative Colitis. Part 1: Definitions, diagnosis, extra-intestinal manifestations, pregnancy, cancer surveillance, surgery, and ileo-anal pouch disorders / Magro F, Gionchetti P, at al. 2017 Feb 2.
      7. Matthew Pinder, Katie Lummis, Christian P. Selinger / Managing inflammatory bowel disease in pregnancy: current perspectives Matthew Pinder, Katie Lummis, Christian P Selinger // Clin Exp Gastroenterol. - 2016; 9: 325-335.
      8. Pedersen N., Bortoli A., Duricova D., et al. // The course of inflammatory bowel disease during pregnancy and postpartum: a prospective European ECCO-EpiCom Study of 209 pregnant women. Aliment Pharmacol Ther. 2013;38(5):501-512.
      9. Rajaratnam SG, Eglinton TW, Hider P, Fearnhead NS. Impact of ileal pouch-anal anastomosis on female fertility: meta-analysis and systematic review. Int J Colorectal Dis. 2011;26(11):1365-1374.
      10. Dubinsky M., Mahadevan U, Vermeire S, Abhyankar B, Lasch K. Vedolizumab exposure in pregnancy: outcomes from clinical studies in inflammatory bowel disease; Poster presented at: Clinical: Therapy & Observation; European Crohns and Colitis Organisation; Barcelona: 2015.
      11. Schulze H, Esters P / Editorial: the management of IBD during pregnancy and lactation - author’s reply / Schulze H, Esters P, Dignass A. //Aliment Pharmacol Ther. 2014 Nov;40(10):1248. doi: 10.1111/apt.12971
      12. Minami N, Matsuura M, Koshikawa Y, Yamada S, Maternal and fetal outcomes in pregnant Japanese women with inflammatory bowel disease: our experience with a series of 23 cases // Aliment Pharmacol Ther. 2017 Apr;45(7):941-950. doi: 10.1111/apt.13960. Epub 2017 Feb 7.
      13. Mahadevan U, Vermeire S / Vedolizumab exposure in pregnancy: outcomes from clinical studies in inflammatory bowel disease // Aliment Pharmacol Ther. - 2017 Apr;45(7):941-950. doi: 10.1111/apt.13960. Epub 2017 Feb 7.
      14. Rahimi R, Nikfar S, Rezaie A, Abdollahi M. Pregnancy outcome in women with inflammatory bowel disease following exposure to 5-aminosalicylic acid drugs: a meta-analysis. Reprod Toxicol. 2008;25:271-275.
      15. Tegethoff M, Pryce C, Meinlschmidt G. Effects of intrauterine exposure to synthetic glucocorticoids on fetal, newborn, and infant hypothalamic-pituitary-adrenal axis function in humans: a systematic review. Endocr Rev. 2009;30:753-789
      16. Beaulieu D. B., Ananthakrishnan A. N., Issa M., Rosenbaum L., Skaros S., Newcomer J. R., Kuhlmann R. S., Otterson M. F., Emmons J., Knox J., et al. Budesonide induction and maintenance therapy for Crohn’s disease during pregnancy. Inflamm. Bowel. Dis. 2009;15:25-28.
      17. Dignass, A. Once versus three times daily dising of oral budesonide for active Crohn’s disease: double-blind, dоuble-dummy, randomised trial / Dignass A., Stoynov S., Dorofeyev A. E., Grigorieva G. A., Tomsová E., Altorjay I., Tuculanu D., Bunganič I., Pokrotnieks J., Kupčinskas L., Dilger K., Greinwald R., Mueller R., Penchev P., Kadian H., Petrov A., Chavushian A., Balabanska R., Tsonev R., Kurktschiev D. et al. // Journal of Crohns & Colitis. 2014. - Т. 8. № 9. - С. 970-980.
      18. Komaki F, Komaki Y, Micic D, Ido A, Sakuraba А. / Outcome of pregnancy and neonatal complications with anti-tumor necrosis factor-α use in females with immune mediated diseases; a systematic review and meta-analysis. // J. Autoimmun. 2017 Jan;76:38-52. Epub. 2016 Nov 30.
      19. Kammerlander H, Nielsen J, Kjeldsen J, Knudsen T, Friedman S, Nørgård B. The Effect of Disease Activity on Birth Outcomes in a Nationwide Cohort of Women with Moderate to Severe Inflammatory Bowel Disease. Inflamm Bowel Dis. 2017 Mar 24. doi: 10.1097/MIB.0000000000001102.
     


    Full text is published :
    Skalinskaya M.I., Bakulin I.G., Zhigalova T.N., Skazyvaeva E.V. et al. INFLAMMATORY BOWEL DISEASE AND PREGNANCY: FROM WORLD EXPERIENCE TO OWN OBSERVATIONS. Experimental and Clinical Gastroenterology Journal. 2017;143(07):184-191
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    1. Separate structural subdivision “Scientific Research Clinical Institute of Pediatrics named after Academician Yu. E. Veltishchev” (Moscow, Russian Federation)
    2. Pirogov Russian National Research Medical University (RNRMU) (Moscow, Russian Federation)
    3. Krasnoyarsk State Medical University named after Prof. V. F. Voino-Yasenetsky (Krasnoyarsk, Russian Federation)
    4. Federal State Autonomous Institution “National Scientific and Practical Center of Children’s Health” Of the Ministry of Health of the Russian Federation (Moscow, Russian Federation)
    5. The Russian Scientific Center for Surgery named after academician B. V. Petrovsky

    Keywords:Wilson’s disease,children,liver function disorder,liver structure disorder,portal hypertension,cirrhosis,international classification of functioning,medical and social expertise

    Abstract:In article we presented dynamic analysis of liver function and structure in children with Wilson’s disease based on the author’s system for determination the degree of liver function and structure disorder that was created on the basis of the International Classification of Functioning using the statistical analysis of the digital expression of a set of changes in indices reflecting major violations of liver function and structures and severity of portal hypertension. We found that that the first examination in children with Wilson’s disease in 96,6 % of cases showed a decrease in the liver function by 25,0-95,0 % corresponding to a moderate and severe degree of impairment, whereas after 6 and 12 months of treatment, similar changes registered significantly less often - in 87,5 %, and 86,6 % of patients, respectively. Moderate and severe disruption of liver structure and severity of portal hypertension according to the offered system at the first hospitalization was noted at 77,8 % of children with cirrhosis in the outcome of Wilson’s disease, after 6 months of therapy in 50,0 % of patients, and after 12 months - only in 36,0 % of children. The ROC analysis of the proposed scoring system established its moderate significance in determining indications for liver transplantation in terms of the extent of liver function impairment and high significance in determining the extent of liver structure disorder and the severity of portal hypertension in children with Wilson’s disease. Thus, the proposed scoring systems for assessing the degree of impairment of the function and structure of the liver can be an objective criterion for assessing the severity of liver damage, controlling its changes in dynamics, assessing the effectiveness of the therapy and indications for liver transplantation. The proposed method can be used to create of “the patient’s model” with Wilson’s disease, followed by the development of standards and protocols for the provision of medical care, and also used in the medical and social expertise of children to determine the degree of disruption of the structure and function of the liver when determining the category of “disabled child”.

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    Full text is published :
    Khavkin A.I., Volynets G.V., Panfilova V.N., Komarova O.N. et al. VIOLATION OF THE STRUCTURE AND FUNCTIONS IN CASES OF WILSON’S DISEASE IN CHILDREN: THE CURRENT STATE OF THE PROBLEM. Experimental and Clinical Gastroenterology Journal. 2017;143(07):192-199
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