Adeline Germain1, Thomas Chateau2,3, Laura Beyer-Berjot, Philippe Zerbib4, Zaher Lakkis5, Aurélien Amiot6, Anthony Buisson7, David Laharie8, Jérémie H Lefèvre9, Stéphane Nancey10, Carmen Stefanescu11, Laurent Bresler1, Laurent Peyrin-Biroulet3. 1. Department of Digestive Surgery, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France. 2. Department of Hepato-Gastroenterology, University Hospital of Grenoble, University of Grenoble Alpes, France. 3. Department of Hepato-Gastroenterology and Inserm NGERE, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France. 4. Department of Digestive Surgery and Transplantation, Huriez Hospital, Université Lille Nord de France, France. 5. Department of Digestive Surgery, Besançon University Hospital, France. 6. Department of Gastroenterology, Henri Mondor Hospital, Creteil University, France. 7. Department of Gastroenterology, Estaing Hospital, Clermont-Ferrand University, France. 8. Department of Gastroenterology, Haut-Leveque Hospital, Bordeaux University, Pessac, France. 9. Department of Digestive Surgery, AP-HP, Hôpital Saint Antoine, Paris, France. 10. Department of Gastroenterology, Lyon-Sud Hospital, Lyon University, France. 11. Department of Gastroenterology, Beaujon Hospital, Paris Diderot University, Clichy, France.
Abstract
BACKGROUND AND AIMS: Crohn's disease (CD) frequently affects young women and may require surgery during pregnancy. Data regarding operation for CD in expectant mothers are scare. MATERIALS AND METHODS: This was a retrospective nationwide survey from the GETAID Chirurgie. Any woman with CD undergoing surgery during pregnancy was eligible. RESULTS: A total of 15 cases were collected between 1992 and 2015. Most operations were performed due to penetrating or stricturing complications. Mean gestational age at delivery was 34 weeks, with a mean birth weight of 2507 g. Maternal post-operative complications occurred in two-thirds of cases. Maternal mortality rate was 6.7% and neonatal mortality rate 9.1%. CONCLUSIONS: This is the largest case series of surgery for CD during pregnancy. This operation may have significant morbidity and mortality for mother, fetus, and newborn. Indication needs to be tailored to maternal status, disease severity, and gestational age. Surgery should be managed by experienced gynecologists, physicians, and surgeons. Active CD may be associated with a greater risk to the fetus than the surgical procedure itself.
BACKGROUND AND AIMS: Crohn's disease (CD) frequently affects young women and may require surgery during pregnancy. Data regarding operation for CD in expectant mothers are scare. MATERIALS AND METHODS: This was a retrospective nationwide survey from the GETAID Chirurgie. Any woman with CD undergoing surgery during pregnancy was eligible. RESULTS: A total of 15 cases were collected between 1992 and 2015. Most operations were performed due to penetrating or stricturing complications. Mean gestational age at delivery was 34 weeks, with a mean birth weight of 2507 g. Maternal post-operative complications occurred in two-thirds of cases. Maternal mortality rate was 6.7% and neonatal mortality rate 9.1%. CONCLUSIONS: This is the largest case series of surgery for CD during pregnancy. This operation may have significant morbidity and mortality for mother, fetus, and newborn. Indication needs to be tailored to maternal status, disease severity, and gestational age. Surgery should be managed by experienced gynecologists, physicians, and surgeons. Active CD may be associated with a greater risk to the fetus than the surgical procedure itself.
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