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Published on: June 24, 2020
Crohn's disease-a chameleon during pregnancy
Ralf Czymek1, Stefan Limmer, Markus Kleemann
1Department of Surgery, University of Luebeck Medical School, Ratzeburger Allee 160, Lübeck, Germany. ralf_czymek@web.de
Langenbeck'S Archives of Surgery
|November 13, 2008
Summary
Pregnancy in women with Crohn's disease (CD) is medically acceptable, though complications like preterm birth and diagnostic delays can occur. Conception during remission is recommended for better outcomes in managing CD during gestation.
Area of Science:
- Gastroenterology
- Obstetrics and Gynecology
- Surgical Management
Background:
- Historically, pregnancy was discouraged for women with Crohn's disease (CD).
- Current medical practice accepts gestation in CD patients despite potential severe complications.
- Advances in management have made pregnancy a viable option for women with CD.
Observation:
- A case series of five pregnant women with CD requiring surgery between 1998 and 2008.
- Analysis of treatment recommendations and management of complications during pregnancy.
- Review of literature regarding CD in pregnancy.
Findings:
- High rates of preterm delivery (60%) and low neonatal weight observed.
- Delayed diagnosis and diagnostic errors were common (80%).
- Surgical indications in pregnancy mirror those in non-pregnant patients; endoscopic surgery offers advantages.
Implications:
- Advise patients to conceive during remission for optimal outcomes.
- Surgical management for CD in pregnancy should follow established guidelines.
- A stoma does not preclude vaginal delivery, offering flexibility in birth options.
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