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Objective. Ulcerative colitis is a chronic inflammatory bowel disease, with multifactorial etiology, mainly determined by immunological and environmental factors. The purpose of this article is to describe an acute episode of ulcerative colitis, its management, and also the negative effects upon the fetus. Case. A 28-yearold secundiparous, at 34 weeks of gestation, presented to our clinic with acute mucous and bloody diarheea, cramping abdominal pain, being admitted with a diagnosis of preterm labour. Following sigmoidoscopy with biopsy and histopathological examination, a diagnosis of acute episode of ulcerative colitis was established, and a treatment with hydrocortisone, double antibiotic therapy and hydroelectrolytic repletion was administered, with initial favourable evolution. At 36 hours after admission, the patient's general status suddenly altered, and a magnetic resonance examination revealed toxic megacolon and acute fetal decompensation. The patient delivered through emergency caesarean section a live, hemodynamically and respiratory stable newborn. Conclusions. A multidisciplinary intervention is required in order to proper manage similar cases. The mother's and newborn's evolution was favourable under specific treatment. [ABSTRACT FROM AUTHOR]

Inflammatory bowel diseases (ulcerative colitis, Chron disease and indeterminate colitis) affect mainly women of childbearing age, resulting in a challenge in obtaining a pregnancy. A quiescent or a good controlled disease before pregnancy and adequate family planning represent a desideratum. Subsequent monitoring of pregnant women with inflammatory bowel disease (IBD) should be multidisciplinary, involving gastroenterologists, obstetricians and neonatologists, with a good knowledge of all pathophysiological implications and the adequacy of the therapeutic plan. The advances in IBD treatment during pregnancy and lactation have resulted in a better materno-fetal outcome. Weak control of the disease correlates with specific complications, such as miscarriage, premature birth, insufficient intrauterine growth, preeclampsia, C-section, and low Apgar score at birth. The association between inflammatory intestinal disease, its treatment and the occurrence of fetal malformations remains controversial, although numerous studies have been conducted to verify this aspect. The use of biological therapy in inflammatory bowel disease in pregnancy has led to a better disease control, but has brought new challenges for obstetricians and neonatologists, in particular due to the possible immunosuppressant syndrome of the newborn. This issue is being discussed with interest by international organizations, and at the European level there is a therapeutic consensus on fertility, pregnancy and breastfeeding in patients with intestinal inflammatory disease. We present a series of cases of inflammatory bowel disease in pregnancies which were addressed to our clinic and the correlation between the disease and the maternofetal outcome. [ABSTRACT FROM AUTHOR]