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01-05-2009 | Original Article

Crohn’s disease—a chameleon during pregnancy

Authors: Ralf Czymek, Stefan Limmer, Markus Kleemann, Philipp Hildebrand, Andreas Schmidt, Thomas Jungbluth, Uwe Roblick, Peter Kujath, Hans-Peter Bruch

Published in: Langenbeck's Archives of Surgery | Issue 3/2009

Abstract

Background

In the past, women with Crohn’s disease (CD) as a risk factor in pregnancy were discouraged from becoming pregnant. Today, by contrast, gestation is medically acceptable in these patients despite several severe complications.

Materials and methods

We present the course of five female patients with CD requiring surgery during pregnancy and giving birth at our institution between 1998 and 2008. These cases as well as our treatment recommendations for patients wishing to have children and our approaches to the management of complications during pregnancy are discussed in the light of the literature.

Results and conclusion

Three of five women had a preterm delivery (26 to 31 weeks’ gestation) with a decreased neonatal weight. Generally, the diagnosis of CD is often delayed and diagnostic errors (four of five women) are not uncommon. The symptoms vary widely and include those typical of pregnancy. Three patients had to have a cesarean and only two patients were able to deliver vaginally. Especially in pregnant patients, the course of the disease is highly variable and difficult to predict. Our experience suggests that patients should be advised to conceive during remission. Indications for surgery in pregnant patients are the same as for nonpregnant women and include perforation, obstruction, hemorrhage, and abscess. The advantages of endoscopic surgery also apply to pregnant patients with acute manifestations. A stoma is not a contraindication to vaginal delivery.

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Title: Crohn’s disease—a chameleon during pregnancy
Authors: Ralf Czymek
Stefan Limmer
Markus Kleemann
Philipp Hildebrand
Andreas Schmidt
Thomas Jungbluth
Uwe Roblick
Peter Kujath
Hans-Peter Bruch
Publication date: 01-05-2009
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 3/2009
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-008-0431-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Crohn’s disease—a chameleon during pregnancy

Abstract

Background

Materials and methods

Results and conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Materials and methods

Results and conclusion

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