Inflammatory bowel disease in pregnancy

Key content Inflammatory bowel disease is a condition that presents in young adulthood and is increasingly frequently seen in women in pregnancy. Prepregnancy counselling helps women to optimise pregnancy timing to reduce the risks of complications. Pregnancy in women with inflammatory bowel disease should be managed in conjunction with gastroenterologists. Newer therapies have been found to be highly effective in inducing rapid remission of active disease where other medical treatment has failed but experience in pregnancy is still limited. Delivery decisions can be complex depending on the disease phenotype and where there has been previous complex surgery. Learning objectives To understand the issues related to inflammatory bowel disease and pregnancy. To gain an overview of the management options for women with inflammatory bowel disease in pregnancy. Ethical issues Is it appropriate to continue biologic therapies in pregnancy with minimal evidence of safety? Should all women with previous surgery for inflammatory bowel disease be offered an elective caesarean section to reduce the risks associated with an emergency caesarean section?