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can someone explain the dangers of a flare up during pregnancy?

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Crohn's Disease
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Posted 2/2/2009 3:45 PM (GMT 0)
Hi there,

I hope this doesn't sound like a stupid question as obviously no one wants to be ill during their pregnancy, but i've read so many posts with people saying 'taking meds is FAR better than risking a fare up during pregnancy' - i keep getting small flare ups (pain and vomiting probably for about a day every month roughly) and i'm keen to know exactly what the danger of this is - i'm 18 weeks at the moment and thankfully all scans etc fine so far. i have been recommended moving to some stronger medicine (azathioprine) which i may well do, i'd just love an explanation of how active crohn's affects the baby and why it's so risky to be flaring.

Thanks so much!
Posted 2/2/2009 5:37 PM (GMT 0)
The definition of "flare" is very subjective. For some, "flare" is used to describe every time they have a symptom. For others "flare" means a clinically significant event that requires aggressive medical intervention ie: intravenous drugs and hydration, hospitalization, widespread inflammation confirmed by blood tests, anemia from blood loss etc.

It is the latter that clearly is to be avoided in pregnancy (or anytime) if possible. Such events are significant stressors for the body and those stresses are only magnified by the stress of pregnancy.

What you are describing, while troubling, is probably of no danger to the developing fetus, even though it is distressing to you. The key here is to make sure that you aren't on a slippery slope. If the episodes remain sporadic, do not increase in frequency or intensity and you remain well and healthy in between, you probably shouldn't need to worry about their impact on the baby. As long as your clinical signs of disease activity -- like platelet counts, sed rates, iron levels, white cell counts etc -- remain within normal values and your ob/gyn is happy with the baby's progress, you should be fine.
Posted 2/2/2009 6:17 PM (GMT 0)
What I was told while pregnant was that all of those categories of higher risk b/c of Crohn's really apply to women with active disease while pregnant. Things like low birth weight and preterm birth are higher when the mom has Crohn's but they really only occur more often than the general population when the mom with Crohn's has active disease. That's why the ideal is to be in remission or have the disease under control.

CONGRATS on your pregnancy, by the way. I absolutely loved being pregnant and miss it. Enjoy every moment and each little kick. My daughter is beautiful and healthy and the best thing in our lives.
Posted 2/3/2009 1:18 AM (GMT 0)
 

Thank you for asking Plum because I was wondering the same thing.  I am trying to weigh my options as I get closer to attempting pregnancy.  I'm not sure if I should come off my Humira or not.  I've only had two flares since being diagnosed in 2007 so i don't know what will happen if I come off the Humira.  I hope your pregnancy goes well!  turn

Posted 2/3/2009 4:52 AM (GMT 0)
Regardless if you are in remession or not, please go to a perinatologist or a high risk OB while pregnant with Crohn's.

If you are having small flares (and like a pp stated, depends on your definition of a flare), you could be putting yourself at multiple risks...

They told me the following:
Being in a flare while pregnant, can cause a miscarriage. At your gestation, it can cause pre-term labor.
Low birth weight as you are not getting enough nutrients which can cause the baby to have inter-uterine growth restriction IUGR

Those are the basics. And, yes, because of the 2 very serious things stated above, you should stay on your Crohn's meds while pregnant. I have 2 Remicade babies and it in no way affected them.

I'm wondering if your pains aren't braxton hick contractions or even quite possible a little back labor? And, the vomitting? Is it not morning sickness? It may not be, but I threw up until 24 weeks from morning sickness.

Keep in mind, as my dietitian explained to me, your baby will suck all the nutrients possible from you. Make sure you are taking a healthy vitamin daily. And, eat lots of protein. I drank 1-2 boosts with high protein daily. I shot for 100g of protein daily and my girls came out at healthy weights for their gestations.

GL and take care. Definitely get into a high risk doc if you are not already with one.
Posted 2/3/2009 4:57 AM (GMT 0)
I was in a flare when I was pregnant, and it ended up killing the baby and nearly killed me.
This is definitely something you want to take more than seriously. You'll be high risk of course so see the proper doctor. There is no reason why you and the baby can't be healthy :) In my case, I became pregnant while coming down from a flare and it turned into a vicious cycle until my body had to reject one or the other so it turned out being an ectopic pregnancy from the pressure.

I wish you the BEST of luck on this. Just please, please be careful. I also know there are plenty of women who have had healthy babies while on humira.
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