Over the past few decades, there has been widespread concern about the increasing proportion of births born by caesarean delivery. The rising rate of primary caesarean section has led to the increased number of obstetric population with a history of prior caesarean delivery. Although this group of women may be offered planned vaginal birth after previous caesarean section (VBAC) or elective repeat caesarean section (ERCS), the VBAC rate is generally low particularly in well-developed countries. In the United States, the VBAC rate has decreased to 8.5% by 2006, while the total caesarean rate has increased to 31.1%.1
Tumor necrosis factor (TNF)-α inhibitors are commonly used in the treatment of inflammatory bowel disease (IBD), but the effects of these agents on pregnancy outcomes remain unclear. Now, a systematic review of the English literature has indicated that they pose little risk to the mother or her infant, even if use is continued through the third trimester.