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Tuesday, 20 December 2022

Crohn's disease high-risk pregnancy

 

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How does surgery for Crohn's disease affect pregnancy?

Even people with Crohn's disease can have healthy pregnancies and deliveries. The important thing is to work closely with your doctor and follow a treatment plan to help keep you and your baby healthy.

 

If you are thinking about becoming pregnant, consult both a gynecologist and a gastroenterologist.

 

Does  affect conception?

If Crohn's disease is advanced, it may be harder to conceive than if it is in remission. Ideally, you should be healthy and in remission during pregnancy.

 

If a father-to-be is taking sulfasalazine (azulfidine) for Crohn's disease, he should talk to his doctor about changing his medication.Sulfasalazine can cause low sperm counts.

 

The drug methotrexate is fatal to fetuses and newborns. If a man is taking methotrexate for Crohn's disease, he should stop taking it for three months before trying to conceive. Women with Crohn's disease should avoid methotrexate before and during pregnancy. If you take methotrexate after giving birth, do not breastfeed

If both parents have her IBD, the chance of a child having her IBD is about 1 in 3. If only one parent has Crohn's disease, the chance that the baby will have Crohn's disease is about 9%.

 

How does Crohn's disease affect pregnancy?

This is likely because pregnancy itself causes suppression of the immune system. This is done to prevent the body from rejecting the baby.

Pregnancy can protect you from future flare-ups of Crohn's disease.It can also reduce the need for future surgery. Relaxin is thought to inhibit the formation of scar tissue.

 

Women with IBD have normal pregnancies and births at the same rate as women without IBD. It can be especially problematic in active Crohn's disease. Active Crohn's disease increases the risk of miscarriage. It also increases the risk of premature birth and stillbirth. However, women with inactive Crohn's disease have a slightly higher risk of miscarriage than pregnant women.

 

Can pregnant women take medication for Crohn's disease?

All medications should be discussed with your doctor during pregnancy, whether you have Crohn's disease or not. In general, medications for Crohn's disease do not change during pregnancy. However, it is possible if your physical condition changes. Of the specific types of drugs used to treat Crohn's disease, only antibiotics and methotrexate should be avoided. This is because it can harm your baby.

These drugs do not appear to cause problems during pregnancy when used in standard doses. Do not take methotrexate if you are pregnant. Also, it should not be taken by men or women wishing to become pregnant. Methotrexate can kill your baby. Also do not breastfeed if you are taking methotrexate.

The aminosalicylic acid class of drugs (5-ASA drugs) do not harm the fetus and do not increase the risk of complications.

(Colazar)

Mesalamine (Apriso, Asacol, Dergicol, Lialda, Pentasa)

Olsalazine (dipentam)

Sulfasalazine (Azulfidine)

 

Additionally, breastfeeding is safe when taking 5-ASA medications.

 

Do not get pregnant if you are taking steroids. If you are taking corticosteroids such as prednisone or other steroids and become pregnant, your doctor will prescribe the lowest dose possible. , the pediatrician should monitor the baby. Biologics such as adalimumab (Humira), adalimumab-atto (Amjevita), Humira biosimilars, infliximab (Remicade) and infliximab-abda (Renflexis), infliximab-dyyb (Inflectra), and Remicade biosimilars are safe seems to be usable. Pregnant. It also does not appear to be excreted in breast milk.

 

If you took vitamins before pregnancy, you can continue to take them. If you are taking sulfasalazine, you should take extra care to get enough folic acid, which prevents neural tube birth defects such as spina bifida.

 

Should pregnant women be tested for Crohn's disease?

If you are pregnant and have Crohn's disease, you can safely get the following treatments as needed:

Colonoscopy

Sigmoidoscopy

Upper endoscopy

Rectal biopsy

Abdominal ultrasound

However, X-rays and CT (computed tomography) scans should be avoided unless absolutely necessary.

 

How does surgery for Crohn's disease affect pregnancy?

 Women who have had an enterectomy (an operation to remove part of the intestine) seem to have no problems during pregnancy. Women who undergo ileostomy may have a lower birth rate. An ileostomy is a procedure in which the end of the small intestine is passed through a hole in the abdomen called a stoma. This is so that waste can be drained into a bag attached to the stoma. It may be best to wait until one year after this surgery to conceive to reduce the risk of the ileostomy falling out or becoming blocked during pregnancy. Some people with Crohn's disease develop fistulas, abnormal passages between organs. If you have a fistula or abscess (a pus-filled cavity) near your rectum and vagina, you may be advised to deliver your baby by caesarean section or caesarean section.

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