F Sergent1, E Verspyck, L Marpeau. 1. Clinique gynécologique et obstétricale, hôpital Charles-Nicolle, centre hospitalier universitaire (CHU) de Rouen, 1, rue de Germont, 76031 cedex, Rouen, France. Fabrice.Sergent@chu-rouen.fr
Abstract
OBJECTIVE: To define the optimal conditions of pregnancy in patients affected by Crohn's disease. MATERIAL AND METHOD: Retrospective study of 25 patients affected by Crohn's disease, followed during eight years at Rouen's University Hospital. RESULTS: Twenty patients added up 34 pregnancies. Seventeen patients at least had a child, adding up 26 livebirths. Among the 17 pregnancies beginning with an active Crohn's disease, this proved to be still active in 16 cases. Among the eight interrupted pregnancies, six had an active disease. Out of the five menaces of preterm delivery stopped or not, four were in push. Eight neonatal hypotrophies were connected to a push. DISCUSSION AND CONCLUSIONS: From a confrontation between the data of the literature and our experience, it emerges the following essential points: when Crohn's disease is quiescent, it does not affect the pregnancy, except a moderate fetal hypotrophy. When the disease is active, the risk of abortion and prematurity increases. There is no influence of the pregnancy on Crohn's disease, when pregnancy arises during a period of quiescence of the disease. Two thirds of the pregnancies of these women take place without new push of their disease. During pregnancy, there is no contraindication as far as the usual treatments of Crohn's disease are concerned, with a limitation however for the use of immunosuppressants.
OBJECTIVE: To define the optimal conditions of pregnancy in patients affected by Crohn's disease. MATERIAL AND METHOD: Retrospective study of 25 patients affected by Crohn's disease, followed during eight years at Rouen's University Hospital. RESULTS: Twenty patients added up 34 pregnancies. Seventeen patients at least had a child, adding up 26 livebirths. Among the 17 pregnancies beginning with an active Crohn's disease, this proved to be still active in 16 cases. Among the eight interrupted pregnancies, six had an active disease. Out of the five menaces of preterm delivery stopped or not, four were in push. Eight neonatal hypotrophies were connected to a push. DISCUSSION AND CONCLUSIONS: From a confrontation between the data of the literature and our experience, it emerges the following essential points: when Crohn's disease is quiescent, it does not affect the pregnancy, except a moderate fetal hypotrophy. When the disease is active, the risk of abortion and prematurity increases. There is no influence of the pregnancy on Crohn's disease, when pregnancy arises during a period of quiescence of the disease. Two thirds of the pregnancies of these women take place without new push of their disease. During pregnancy, there is no contraindication as far as the usual treatments of Crohn's disease are concerned, with a limitation however for the use of immunosuppressants.