| Abstract [eng] |
Introduction. Crohn's disease is a chronic inflammatory bowel disease that can affect any part of the digestive tract. Crohn's disease might be caused by genetic predisposition, peculiarities of the intestinal microflora, lifestyle, environmental factors. It leads to inadequate intestinal mucosal immune response and impaired epithelial barrier function. Objectives. To discuss the impact of Crohn's disease on pregnancy and the impact of pregnancy on Crohn's disease, to present and discuss possible preventive measures for Crohn's disease when planning pregnancy. Case report. A clinical case is about a 8 weeks pregnant 34-year-old woman suffering abdominal pain. Crohn's disease, chronic erosive gastropathy, and anemia due to malabsorption syndrome were diagnosed 5 years ago. She was treated with mesalazine, azathioprine, prednisolone, omeprazole, and iron supplements. The patient discontinued treatment a year ago. 2 weeks ago due to abdominal pain resumed mesalazine treatment. After inspection was decided to continue Crohn's disease treatment with mesalazine, azathioprine and a short course of prednisolone. At 30 weeks of gestation patient arrived to hospital due to severe abdominal pain. No obstetric pathologies were observed. Infiltrative changes in the right iliac region, narrowing of the iliac lumen, signs of small intestinal obstruction were found. During the urgent laparotomy surgery, the ileocecal angle was removed. At maturity, a newborn weighing 3,800 g and 54 cm tall was born during caesarean section, rated 9/10 by Apgar scale. Conclusions and suggestions. Remission of Crohn's disease for at least 6 months is recommended when planning a pregnancy. It is recommended to continue treatment, to avoid stress, use vitamin D and folic acid supplements, reduce the intake of fiber, fat and lactose. |
