Surgery for Crohn’s disease during pregnancy: A nationwide survey
Adeline Germain, Thomas Chateau, Laura Beyer‐Berjot, Philippe Zerbib, Zaher Lakkis, Aurélien Amiot, Anthony Buisson, David Laharie, Jérémie H. Lefèvre, Stéphane Nancey, Carmen Stefănescu, Laurent Bresler, Laurent Peyrin‐Biroulet, GETAID Chirurgie
Abstract
BACKGROUND AND AIMS: Crohn's disease (CD) frequently affects young women and may require surgery during pregnancy. Data regarding operation for CD in expectant mothers are scare. MATERIALS AND METHODS: This was a retrospective nationwide survey from the GETAID Chirurgie. Any woman with CD undergoing surgery during pregnancy was eligible. RESULTS: A total of 15 cases were collected between 1992 and 2015. Most operations were performed due to penetrating or stricturing complications. Mean gestational age at delivery was 34 weeks, with a mean birth weight of 2507 g. Maternal post-operative complications occurred in two-thirds of cases. Maternal mortality rate was 6.7% and neonatal mortality rate 9.1%. CONCLUSIONS: This is the largest case series of surgery for CD during pregnancy. This operation may have significant morbidity and mortality for mother, fetus, and newborn. Indication needs to be tailored to maternal status, disease severity, and gestational age. Surgery should be managed by experienced gynecologists, physicians, and surgeons. Active CD may be associated with a greater risk to the fetus than the surgical procedure itself.