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

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plum
New Member


Date Joined Jan 2009
Total Posts : 4
   Posted 2/2/2009 8:45 AM (GMT -7)   
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!

belleenstein
Veteran Member


Date Joined Feb 2007
Total Posts : 1010
   Posted 2/2/2009 10:37 AM (GMT -7)   
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.
Belleenstein:

30+ years living with Crohn's.


inflamed
Veteran Member


Date Joined Nov 2005
Total Posts : 1340
   Posted 2/2/2009 11:17 AM (GMT -7)   
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.
Hoping to stay in remission after the birth of a healthy baby girl. On Pentasa during my pregnancy, went med-free 2 months to nurse (stupid), but back on Pentasa and still nursing.


Jessica28
Regular Member


Date Joined Jan 2009
Total Posts : 21
   Posted 2/2/2009 6:18 PM (GMT -7)   
 
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
Jessica
 
28 years old, diagnosed with Crohn's  in March, 2007.  Currently taking Humira 2 X month


Kaycie
Regular Member


Date Joined Jan 2006
Total Posts : 449
   Posted 2/2/2009 9:52 PM (GMT -7)   
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.
Kaycie - Age: 26
Crohn's - Dx Nov 05
Failed Remicade, moving onto a Clinical Trial called ABT-874 - Tentative start date - 10/2/08 - 10/16/08  - Infusion, every 4 weeks.
IVF #1 (In-Vitro Fertilization) - Failed
IVF #2 - IVIg, Heparin, Baby Aspirin - TWIN GIRLS!!!
Reagan Dawn - 8/2/07 - Lived 1 hour 27 minutes due to Cloaca, NOT affiliated with my Crohn's
Addison Maria - 8/2/07 - 13 months old


LMills
Veteran Member


Date Joined Apr 2008
Total Posts : 1753
   Posted 2/2/2009 9:57 PM (GMT -7)   
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.
20 years old, Diagnosed with moderate to severe Crohn's and Colitis in May of 2008.
Currently taking:
Prednisone 15 mg, pentasa 2 pills 4x a day, bentyl as needed, omeprazole in the morning, multivitamin, humira every other week, and good probiotics.
Surgery for ectopic pregnancy most likely the result of severe Crohn's inflammation in July of 2008.
Attempting a diet without refined sugars, high fat content, bleached or bromated flour, most dairy, red meat, and avoiding anything spicy like the plague. Also refuse to eat anything with trans fat or high fructose/corn syrup.
"He who has a why to live for can bear with almost any how."

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