Crohn’s disease in women

Abstract

Ivana Plavšic,1 Tea Štimac,2 Goran Hauser31Health Center, County of Primorje-Gorski Kotar, Rijeka, Croatia; 2Department of Gynecology, 3Department of Gastroenterology, Clinical Hospital Center Rijeka, Rijeka, CroatiaAbstract: This article provides an overview of the obstetric and gynecological manifestations of Crohn’s disease (CD). High incidence of the new onset of the disease in young women in their reproductive years demands special concern from physicians involved in their treatment. Pregnant women with CD are considered high-risk patients, regardless of disease activity index, due to associated complications. Predominately described complications are premature birth, low birth weight, and congenital anomalies. To minimize the risk for adverse pregnancy/birth outcomes, it is recommended that remission be achieved before conception. Treatment of CD in pregnant women is similar to that among the nonpregnant population, and there is no valid reason to terminate it, since most of the drugs are proven to be safe. Women with CD who wish to conceive or are already pregnant need to be properly advised according to the newest guidelines on the subject, given by the European Crohn’s and Colitis Organization. Gynecological manifestations are another special feature of CD. They are important in that they may facilitate early recognition of the underlying disease, which usually stays unrecognized for years before intestinal manifestation; in this way, the underlying manifestations are often mistreated.Keywords: adverse pregnancy outcome, Crohn’s disease, gynecological complications, immunosuppressive therapy