Colorectal Diseases Often Pose Little Fetal Risk. (Crohn's Disease, Ulcerative Colitis).

ORLANDO, FLA. - Maternal Crohn's disease does not appear to be linked to fetal complications unless the disease is active and severe, Dr. Jeffrey P. Snow said at a meeting of the One Kilo Club.

Dr. Snow, chief of surgery at Memorial Hospital Pembroke in Pembroke Pines, Fla., reviewed the medical literature to offer guidance to ob.gyns. about special issues concerning fertility and pregnancy in women with colorectal diseases. He found no clear evidence that Crohn's disease affects fertility; except among women who had undergone surgery for their disease.

Women with quiescent Crohn's disease at the time of conception will have about a 25% chance of having disease recurrence during pregnancy. Among those with active disease at the time of conception, one-third will get better, one-third will get worse, and one-third will experience no change in disease severity during pregnancy, Dr. Snow said at the meeting, held in conjunction with the 37th International College of Surgeons' North American Federation Congress.

Studies suggest that Crohn's disease is not linked to a higher rate of miscarriages or stillbirths, but mothers with the disease may have significantly lower-birth-weight babies-especially if mothers have poor weight gain-and more preterm births than healthy mothers. Among women with severe, active disease, rates may be elevated for fetal loss and prematurity.

Several studies suggest that vaginal delivery, especially with episiotomy, can lead to perineal disease, even among women who did not have perineal disease previously.

Surgery for Crohn's disease-related intraperitoneal sepsis has been reported in just one study. In five of six cases, post-surgical patients were delivered of healthy babies, although one surgery resulted in an anastomotic leak and a miscarriage.

Turning to ulcerative colitis, ...