Friday, July 18, 2008

Active Crohn's Disease and Pregnancy

Active Crohn's Disease during pregnancy can be managed with proper health care. I personally would recommend all women with Crohn's to see the care of a Perinatologist. These doctors specialized solely in the care and health of your unborn baby. While your GI would never wish any harm to your baby, their job is to care for your digestive system and OB's are very broad in their treatments.

When seeing a Peri be prepared for more doctors visits. This is not a bad thing though because it will allow you to see your baby more often and also provide close medical care of your baby. Most doctors will tell you that active Crohn's will stay active during your pregnancy and inactive Crohn's will stay inactive during pregnancy. This can be true but do not live by it, our health and bodies are very tricky things and your health can change at a moments notice.

Crohn's Disease especially active Crohn's can increase your chances of pre-term birth. I personally delivered 4 weeks early. I was lucky and my son had no complications aside from normal jaundice.

As soon as you find out you are pregnant you need to contact your OB/Gyn and your GI doctor. Many common medications taken to treat Crohn's Disease is not safe for use during pregnancy. One that is especially dangerous is methotrexate. Methotrexate (Category X) and thalidomide (Category X) are two immunosuppressive drugs that should not be used during pregnancy as they do have an effect on an unborn child. Methotrexate can cause abortion and skeletal abnormalities, and it should be discontinued three months prior to conception, if possible. Thalidomide is well known for causing limb defects as well as other major organ complications in a fetus. Use is only permitted with rigorous birth control and frequent pregnancy testing.

Imuran and 6-MP (Category D) do cross the placenta and can be detected in cord blood. However, they might be recommended with caution during pregnancy by some physicians to combat a serious flare-up. These drugs do not increase the risk of birth defects.

So it is very important to contact your doctors as soon as you find out that you are pregnant.


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