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Re: Crohn's and Pregnancy/DeliveryFrom: bclaure (bclaure@club-internet.fr)Thu Dec 12 15:45:22 1996
James Banks wrote: > > A former resident called me today and asked for advice on managing a > primigravid patient who has severe Crohn's disease, including one or > two perirectal fistulas communicating onto the perineum. Should > these patients be delivered by elective cesarean in order to reduce > > the chances of increasing perirectal/perineal fistula? > > My thoughts were that she should have a cesarean only for obstetrical reasons as per usual. Anyone have other thoughts or advice? > > Thanks, > 1) In a primigravid episiotomy is frequent and the Crohn's fistulas are probably posterior, so difficulties for vaginal delivery. on the other hand 2) If she has already undergone surgery a CS can be "a good sport" good luck! Bernard Cristalli MD CNGOF Paris - France
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