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Crohn's disease in pregnancy — ESEGH MCQ

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HardInflammatory Bowel DiseaseCrohn's disease in pregnancyESEGH

A 30-year-old woman with Crohn's disease is 10 weeks pregnant. She is in remission on adalimumab and azathioprine, with a previous severe flare when treatment was stopped. She asks whether to stop both drugs until delivery. What is the most appropriate management?

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Correct answer: C — Continue maintenance therapy after counselling about risks and benefits

Active IBD is a major risk to pregnancy outcomes, and many maintenance therapies including anti-TNF agents and thiopurines can be continued when benefits outweigh risks. Methotrexate is contraindicated in pregnancy. Stopping effective therapy in a patient with previous severe relapse risks harm. The pearl is that disease control before and during pregnancy is usually the safest strategy.

Reference: BSG IBD Guideline 2025; BNF Pregnancy Prescribing