Clinical Expert Series
Care of the Pregnant Patient With Inflammatory Bowel Disease
Uma Mahadevan, MD and Rebecca Matro, MD
Obstet Gynecol 2015;126(2)
Continuing Medical Education credit is provided through joint sponsorship with
The American College of Obstetricians and Gynecologists.
ACCME Accreditation
The American College of Obstetricians and Gynecologists (the College) is accredited by the Accreditation Council for
Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
AMA PRA Category 1 Credit(s)™
The American College of Obstetricians and Gynecologists designates this enduring material for a maximum of 2 AMA PRA
Category 1 Credits.™ Physicians should claim only the credit commensurate with the extent of their participation in the activity.
College Cognate Credit(s)
The American College of Obstetricians and Gynecologists designates this enduring material for a maximum of 2 Category 1
College Cognate Credits. The College has a reciprocity agreement with the AMA that allows AMA PRA Category 1 Credits™ to
be equivalent to College Cognate Credits.
Disclosure Statement
Current guidelines state that continuing medical education (CME) providers must ensure that CME activities are free from the
control of any commercial interest. All authors, reviewers, and contributors have disclosed to the College all relevant financial
relationships with any commercial interests. The authors, reviewers, and contributors declare that neither they nor any
business associate nor any member of their immediate families has financial interest or other relationships with any
manufacturer of products or any providers of services discussed in this program. Any conflicts have been resolved through
group and outside review of all content.
Submission
Before submitting this form, please print a completed copy as confirmation of your program participation.
College Fellows: To obtain credits, complete and return this form by e-mail (obgyn@greenjournal.org) or fax (202-4790830). Your score, and a copy of the answer key, will be e-mailed to you after receipt of a completed quiz. Credit will be
recorded for those participants answering 80–100% of questions correctly. College Fellows may check their transcripts
online at http://www.acog.org, and any questions related to transcripts may be directed to educationcme@acog.org. For other
queries, please contact the Obstetrics & Gynecology Editorial Office, 202-314-2317 (phone) or obgyn@greenjournal.org (email).
Non–College Fellows: To obtain credits, submit the printout of the completed quiz to your accrediting institution. The printout
of the completed quiz is documentation for your continuing medical education credits.
Continuing medical education credit for “Care of the Pregnant Patient With Inflammatory Bowel Disease” will be available
through August 2018.
1. The factor that most influences fertility rates for women with inflammatory bowel disease is:
Disease type
Duration of disease
Length of bowel affected
Portion of bowel affected
Prior surgery
CME Quiz for the Clinical Expert Series
Obstet Gynecol 2015;126(2)
Credit available through August 2018
Page 1 of 4
2. The lower rate of childbearing among women with inflammatory bowel disease compared to other
women is primarily due to:
Heritability of the disease
Physician recommendation
Reduced fertility
Safety of medications during pregnancy
Voluntary childlessness
3. A patient has had inflammatory bowel disease for 8 years. She has no family history of primary
sclerosing cholangitis or colon cancer. The most appropriate cancer screening strategy for this patient
is:
Computerized tomographic virtual colonoscopy
Colonoscopy with chromoendoscopy
Double contrast barium enema
Fecal occult blood testing
Flexible sigmoidoscopy
4. An inflammatory bowel disease flare may be suggested by an extreme increase in:
Creatinine clearance
Sedimentation rate
Serum folic acid
Serum iron
Vitamin D level
5. Ideally, women with inflammatory bowel disease should attempt conception when they:
Are having 3 or fewer diarrheal stools per day
Can be weaned off all medications for the duration of the pregnancy
Have been in remission for at least 6 months
Have been in remission for at least 12 months
Have completed any planned surgical therapies for their bowel disease
6. The greatest risk of inflammatory bowel disease flare in the peripartum period occurs when women:
Attempt to breastfeed
Discontinue medications
Enter the second trimester
Receive labor augmentation with prostaglandins
Undergo vaginal delivery
CME Quiz for the Clinical Expert Series
Obstet Gynecol 2015;126(2)
Credit available through August 2018
Page 2 of 4
7. Pregnant women with a history of inflammatory bowel disease who experience diarrhea should be
tested for:
Colonic stricture
Clostridium difficile
Escherichia coli
Occult blood
Pseudomonas infection
8. Which of the following medications used to treat inflammatory bowel disease is contraindicated
during pregnancy or breastfeeding?
Amoxicillin-Clavulanic acid
Ciprofloxacin
Infliximab
Methotrexate
Prednisone
9. In the Pregnancy in Inflammatory Bowel Disease and Neonatal Outcomes registry, after controlling
for disease activity and concurrent immunosuppressive medications, maternal corticosteroid use was
associated with a significant increase in:
Cesarean delivery
Infant infections within the first 4 months of life
Low birth weight
Omphalocele
Preeclampsia
10. In utero anti-TNF drug exposure late in pregnancy has raised concerns regarding:
Development of the infant immune system
Infantile asthma
Infantile breast milk metabolism
Infantile irritable bowel syndrome
Neonatal necrotizing enterocolitis
CME Quiz for the Clinical Expert Series
Obstet Gynecol 2015;126(2)
Credit available through August 2018
Page 3 of 4
College ID Number:
Name:
Address:
City/State/Zip:
E-mail Address:
Actual time spent completing this activity (you may record up to 2 hours):
CME Quiz for the Clinical Expert Series
Obstet Gynecol 2015;126(2)
Credit available through August 2018
Page 4 of 4