COURSE OF CROHNS-DISEASE DURING PREGNANCY AND ITS EFFECT ON PREGNANCYOUTCOME - A RETROSPECTIVE REVIEW

The purpose of our study was to review the effects of Crohn's disease on pregnancy outcomes. Over a 6-year period, we identified 17 women wi th pregnancies complicated by Crohn's disease. The mean age of the wom en was 26 years, with a mean age of diagnosis at 17 years. Crohn's dis ease worsened only slightly during the pregnancy. Exacerbations of dia rrhea were the main problems. Weight gain, unadjusted for gestational age at delivery, was 18 pounds. Three babies had low birthweight; two were both premature and growth retarded. One woman with active disease and no prenatal care had a fetal death at 30 weeks' gestation with su bsequent disseminated intravascular coagulation. Among women with acti ve perianal disease, one was delivered vaginally without exacerbation of symptoms. Four women with histories of perianal disease had prophyl actic primary elective cesarean sections to avoid worsening of symptom s. Three of these women developed recurrent perianal disease despite t he abdominal delivery. One of these developed an abdominal fistula tra it in the wound. Our findings suggest that active disease at the onset of pregnancy tends to remain active, and quiescent disease tends to r emain quiescent. Mode of delivery in our series was not protective aga inst perineal disease. Although our series is small, it suggests that delivery may occur vaginally, with operative delivery reserved for obs tetric indications.