Crohn's Disease and Pregnancy - Health Education - DesiMD Healthcare - India

Crohn's Disease and Pregnancy

Authored by DesiMD Doctor on 13 Mar 2016 - 23:08

Crohn's Disease

Crohn's disease is a type of IBD (inflammatory bowel disease) that causes inflammation of the lining of your digestive tract, which can lead to severe diarrhea, weight loss and abdominal pain. It is a chronic illness in which the bowel, intestine or any other part of the digestive tract becomes ulcerated (marked with sores) or inflamed. Crohn's disease can affect the colon and small intestine or both, of a pregnant woman.  Although the exact cause of Crohn's disease is unknown, experts believe that this disease can be aggravated due to stress or poor diet. Studies have shown that genetic, immunologic and environmental factors also play an important role in development of this disease in a pregnant woman.

Unexpected symptoms of Crohn's disease during pregnancy: People with Crohn's disease suffer from severe symptoms, which can last for weeks or years. Some of them include:

  • Sudden weight loss
  • Chronic diarrhea
  • Fever
  • Abdominal pain (mostly on the right side of lower abdomen)
  • Bloody stools
  • Feeling of a mass or fullness in the lower, right abdomen
  • Loss of appetite
  • Urgency in bowel movement
  • Feeling tired

Risk of Crohn's disease during pregnancy:

Several studies have examined the effect of IBD, Crohn's disease and ulcerative colitis on the outcome of pregnancy and the health of the child and have found that nearly 85 percent of pregnant women experience uncomplicated and normal pregnancies. Congenital malformations in infants born from women affected with Crohn's disease occur in not more than one percent. The risk of miscarriage also does not seem to increase.

Can a pregnant woman have a normal delivery?

Yes! You can have a normal delivery, only if your anus and vagina are healthy and the disease does not affect them. But, if the disease affects the anus area or the area around it, then you may require a C-section (cesarean section) in order to reduce the risk of a fistula.

How can Crohn's disease be diagnosed during pregnancy?

The health care team might do any one of the following to diagnose Crohn's disease in pregnancy:

  • Physical examination
  • Upper GI series
  • Check family and medical history
  • Intestinal endoscopy
  • Scan

Pregnancy and Crohn's Treatment:

Most studies have proved it safe to take medicines to treat Crohn's disease. However, some medications that control inflammation from Crohn's disease can disrupt the effectiveness of a folate. Deficiency of folate can result in premature delivery, slow a baby's growth and low birth weight and can also cause neural tube defects, which can lead to diseases such as spina bifida (a spinal disorder), malformation and anencephaly (a brain disorder). However, one should consult with their healthcare team about getting the correct dosage of folate.

How to manage Crohn's disease during pregnancy?

Most of the women experience an eruption of Crohn's disease during the first trimester of pregnancy because they discontinue taking their medications. However, most Crohn's disease medications like immunomodulators can be well tolerated during pregnancy, but Methotrexate has been associated with effects like miscarriage and birth defects and hence should be avoided.

Dr Sunanda, Shirley Division of Gastroenterology and Hepatology, Mayo clinic college of Medicine, recommends pregnant women to keep several factors in mind when managing the condition:

  • If a woman has a disease flare during pregnancy, she may need hospitalization predominantly for nutritional support and closer fetal monitoring in order to get the disease under control.
  • Supplementation with extra folate, protein and iron is encouraged during pregnancy because maternal loss of these nutrients can occur fast.
  • For a patient on a biologic agent, therapy should be carried on through the first and second trimesters and discontinued in the third, because IgG (immunoglobulin G) is actively transported across the placenta and fetal exposure is at its highest. However, infants born to mothers on immunosuppressant therapies should not get live virus vaccines during the first 8 to 12 months of life (rotavirus vaccine) until more is known about the immunologic environment of these children.
  • Vaginal delivery is encouraged except in cases of a history of fistulas or active perianal disease.


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