Rogers R G, Katz V L
U.N.C. School of Medicine, Department of Obstetrics & Gynecology, Chapel Hill 27599-7570, USA.
Am J Perinatol. 1995 Jul;12(4):262-4. doi: 10.1055/s-2007-994469.
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 with pregnancies complicated by Crohn's disease. The mean age of the women was 26 years, with a mean age of diagnosis at 17 years. Crohn's disease worsened only slightly during the pregnancy. Exacerbations of diarrhea 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 subsequent disseminated intravascular coagulation. Among women with active perianal disease, one was delivered vaginally without exacerbation of symptoms. Four women with histories of perianal disease had prophylactic primary elective cesarean sections to avoid worsening of symptoms. Three of these women developed recurrent perianal disease despite the abdominal delivery. One of these developed an abdominal fistula trait in the wound. Our findings suggest that active disease at the onset of pregnancy tends to remain active, and quiescent disease tends to remain quiescent. Mode of delivery in our series was not protective against perineal disease. Although our series is small, it suggests that delivery may occur vaginally, with operative delivery reserved for obstetric indications.
我们研究的目的是回顾克罗恩病对妊娠结局的影响。在6年的时间里，我们确定了17名妊娠合并克罗恩病的女性。这些女性的平均年龄为26岁，平均诊断年龄为17岁。克罗恩病在孕期仅略有加重。腹泻加重是主要问题。未根据分娩时的孕周调整的体重增加为18磅。3名婴儿出生体重低；2名早产且生长受限。1名患有活动性疾病且未接受产前护理的女性在妊娠30周时发生胎儿死亡，随后出现弥散性血管内凝血。在患有活动性肛周疾病的女性中，1名经阴道分娩，症状未加重。4名有肛周疾病史的女性接受了预防性择期剖宫产以避免症状恶化。其中3名女性尽管经腹分娩仍出现复发性肛周疾病。其中1名在伤口处出现腹部瘘管特征。我们的研究结果表明，妊娠开始时的活动性疾病往往会持续存在，而静止性疾病往往会保持静止。我们系列研究中的分娩方式对会阴疾病没有保护作用。尽管我们的系列研究规模较小，但表明可以经阴道分娩，手术分娩仅用于产科指征。
