Surgeons have been reluctant to perform ileostomy for intractable ulcerative colitis in young women because the existence of the ileostomy was believed to militate against pregnancy and subsequent parturition. This belief is unsettled by a study of seven patients with ileostomy and colectomy. In all there were 13 subsequent pregnancies, of which 3 terminated in early spontaneous abortions while 10 went on to term and resulted in live births. In 9 of the 10 term pregnancies the patient was delivered per vaginam, and only one had to be delivered by cesarean section. There was no maternal mortality. In the past, unpredictable exacerbations of ulcerative colitis have been a serious danger in pregnancy. The experiences here recorded show that young women with otherwise intractable colitis can be treated by ileostomy and colectomy without fear of subsequent inability to bear children.
JAMA – American Medical Association
Published: Jan 17, 1959