Pregnancy and stomas: a 9‐year retrospective series at a major metropolitan hospital in Brisbane Queensland

Author:

Kelly Madeleine Louise12ORCID,Fullerton Alexandra3,Cao Amy Millicent Yesheng14ORCID,Colbran Rachel25,Kimble Rebecca23,Clark David A.12ORCID

Affiliation:

1. Department of Colorectal Surgery Royal Brisbane and Women's Hospital Brisbane Queensland Australia

2. Faculty of Medicine University of Queensland Brisbane Queensland Australia

3. Department of Obstetrics and Gynaecology Royal Brisbane and Women's Hospital Brisbane Queensland Australia

4. Department of Colorectal Surgery Westmead Hospital Sydney New South Wales Australia

5. Department of General Surgery Mater Hospital Brisbane Queensland Australia

Abstract

AbstractBackgroundOver 42 000 Australians live with a stoma, and this number increases annually. Pregnancy in stoma patients is a rare but complex condition and there is limited published literature regarding surgical and obstetric complications in pregnant stoma patients. The aim of this paper was to review stoma outcomes, perinatal morbidity and mortality, and early postpartum period in pregnant stoma patients.MethodsData was retrospectively obtained on women of childbearing age, with a stoma, who had been pregnant and birthed in the last nine years at the Royal Brisbane and Women's Hospital between January 2014 to December 2022. Data recorded included patient demographics, type of stoma, indication for stoma, need for additional abdominal surgeries, method of conception, pregnancy complications, length of stay, neonatal outcomes and post pregnancy stomal complications.ResultsIn total, there were 16 births from 13 mothers with stomas. Of 10 births to IBD patients, 40% experienced a serious stomal complication. Caesarean section (CS) rate was 90% for IBD and 83% for non‐IBD. In‐vitro fertilisation rates were 40% in IBD patients and 0% in non‐IBD patients. The average gestational age at delivery was 36 weeks in IBD and 35 weeks in non‐IBD patients. Neonates delivered to IBD mothers had a birth weight under 2500g in 40% of cases and in non IBD mothers at 33.3% (p = 0.62). Of the sixteen births there was five complications (31.25%) associated with the stoma either during pregnancy or during the sixty‐day postpartum period.ConclusionPregnancy in stoma patients is a rare occurrence and appears to be associated with high rates of CS, preterm delivery, low birth weight and stomal complication.

Publisher

Wiley

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