Crohns and Pregnancy

I hate to have to tell you this, but both your GI and your OB gave you bad advice. That kinda annoys me, so I can imagine it annoys you too.

Imuran, at the dosages used for Crohn's, is safe during pregnancy. So is Cimzia. So is lexapro. The one that is absolutely not is methotrexate.

A healthy baby is more likely if the mother is kept from flaring. The meds help that (well, not always...).

How long ago did you stop the meds? Could you get back on them?

Could you find a GI and an OB who know what the heck they're doing? Grrr..... All it takes is five minutes of research on their part, and they didn't bother to do it.

Ummm, both your GI and your OB are complete morons. ANY Crohn's doctor who knows what they are talking about know that it is IMPERATIVE for your pregnancy for you to stay in remission. Flaring will cause pre-term labor, miscarriage, or in the best-case scenario, your baby to be small and malnourished.

Imuran is definitely fine for pregnancy. Seriously. A good friend of mine who also has Crohn's was on 150 mg her entire first pregnancy (under direction of her OB and GI) and is just fine. I am currently pregnant with my second child and am on Remicade. I did Remicade all through my first pregnancy as well, and my now 2 year old daughter is completely healthy and fine.

Entocort isn't the greatest for pregnancy because a steroid messes with hormone production and can alter the baby's formation of their steroid-producing glands. However, it is probably better than prednisone, and I was on pred twice in my first pregnancy for a couple weeks each time because I started flaring from dehydration (I had super bad hyperemesis). Once we got dehydration under control by doing daily IV fluids, it was just fine. However, my OB, high-risk OB, and GI all agreed that steroids were better for me and the baby than to be flaring. Period.

In the list of things that are bad for you for pregnancy, flaring is probably the worst over everything, including heavy-duty meds.

One pregnancy med, either Cimzia or Entyvio (sorry I can't remember which) was brought up by my GI in my last appointment as being even safer than Remicade or Humira because it actually doesn't cross the placental barrier at all. He brought it up because there's a small possibility I'm allergic to Remicade (it's that or sulfites in food), so we may need to switch.

I am concerned that your GI was continuing budenoside with you with Cimzia not working. Why weren't you trying a different maintenance medication to replace it? Steroids are NOT meant to be a long-term treatment for Crohn's.

I have been pregnant in three different states in the US, and ALL are in agreement with what I've outlined above. I'm really angry with your doctors; they sound completely uneducated and uninformed.

Although she is now 11, I was on 150mg azathioprine during my third pregnancy. Everyone advised me to remain on and all research at the time supported this. I've not heard of any adverse effects ... True things may come to light years down the line ... But nothing I've read to date. My daughter appears to be absolutely fine.

I would loved to have not taken any drugs, but felt that the only other option, a severly ill mother, was a greater risk. Good luck with your pregnancy and i recommend you dig out some stats for yourself to help you decide the best course of action for you.

Thank you for all the advice! I was taking 9mg total to entocort and 100mg of imuran. I actually saw a doc at the Cleveland Clinic last January about my Crohns options after a nasty flare because my GI down here wanted to put me on Intivyo. However, I never followed back up with him because he was "out of network" on the insurance, and my bill was $600. It's hard to afford that and the medications and life at the same time! :/

Lexapro is debatable but severe anxiety is a risk for the fetus.
There are alternatives they can use.

Please see another doctor who specializes in ibd.
Even though Cleveland clinic is out of network, often big hospitals will give discounts.
I saw a dietician at university of Chicago and I thought I would be covered by insurance. Turns out my insurance didnt cover it. I called the billing department to ask for a discount and they waved the entire bill.
See what you can do. Call Cleveland before you go and ask if they have any options.
If they won't give you a big discount they will most likely be willing to give you the price insurance would pay for a service.
For example a medication costs 90 dollars but insurance paid 37 ask them if you can pay 37

scifigal2k said...
Ummm, both your GI and your OB are complete morons. ANY Crohn's doctor who knows what they are talking about know that it is IMPERATIVE for your pregnancy for you to stay in remission. Flaring will cause pre-term labor, miscarriage, or in the best-case scenario, your baby to be small and malnourished.



In the list of things that are bad for you for pregnancy, flaring is probably the worst over everything

I was flaring between moderate to severe with my second pregnancy and not on any meds due to being either allergic or non-responsive to them...it did not cause me to have pre-term labor, miscarriage or a small malnourished baby.

I had an excellent pregnancy from beginning right to full term and natural delivery (45 minutes) never had morning sickness or nausea, had an 8lb 3 oz healthy baby boy that is 22 years old now and still healthy.

Not saying that anyone should go off their pregnancy-safe meds as was suggested by the OP's GI and OB (I agree they're both nuts) but just reminding everyone that nothing is written in stone either and everyone is individual when it comes to the possible complications of IBD and pregnancy.