pregnancy & fertility

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Pregnancy and IBD

Postby oneup_twodown on Fri Mar 08, 2013 4:17 pm

Im currently 35 weeks pregnant and have a diagnosis of Crohns Colitis. Ive been very well throughout my pregnancy and ive been able to reduce and cease taking all my immunosuppressant medication. Otherwise Ive had no complications of flare ups of my condition for the last 8 months.

Ive had operations in the last two years for abscesses and fistulas and currently have significant perianal scarring. As I approach birth Im becoming increasingly worried about having a natural birth as Im afraid if I have any complications I may become faecally incontinent due to a vaginal delivery? I would appreciate any advice or areas I could address with my midwife or consultant regarding this? Im due to see my IBD consultant in 3 weeks.
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Re: Pregnancy and IBD

Postby Dr Amanda Tristram on Fri Mar 08, 2013 10:20 pm

Being worried about faecal incontinence in this situation is very understandable. It is certainly worth talking to both your midwife and consultant about this. What you want to know is what are the risks of having a normal birth compared to the risks of having a Caesarean section. Obviously this will be different for everyone. If you have had previous abdominal surgery, then the risks for the Caesarean section will be increased. I think it will be difficult for you doctor to give you and exact risk of either, but it will probably be very helpful to discuss it with them.
Dr Amanda Tristram
Senior Lecturer in Gynaecological Oncology
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Re: Pregnancy and IBD

Postby Mr. Hugh Byrne, MRCOG on Sat Mar 09, 2013 9:43 pm

To be frank, with your history of perianal complications, I would opt for an elective caesarean section. While most women's tears are small, you are not 'most women'.
Mr Hugh Byrne
Consultant in Obstetrics and Gynaecology
St Georges Hospital

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