A case report of a woman developing ulcerative colitis during the second trimester

Abstract

A 29-year-old, gravida 1 para 0, woman was diagnosed with diarrhea and frequent bleeding since 21 weeks of pregnancy and admitted to the Department of Gastroenterology at 23 weeks, three days of pregnancy with suspected ulcerative colitis. Ulcerative colitis was diagnosed by lower gastrointestinal endoscopy and treatment was initiated. Administration of five-aminosalicylic acid (5-ASA 4800 mg) formulation was not sufficiently effective; hence, steroid administration (prednisolone [PSL] 60 mg) was also initiated. From the next day, the symptoms improved gradually, and steroid dosage was gradually tapered. Even after that, remission was maintained without symptom exacerbation, and she was discharged at 32 weeks, three days of pregnancy. The disease was stable even after discharge, and fetal growth was unremarkable. The patient experienced labor at 38 weeks, four days of pregnancy and delivered vaginally. The mother and baby were healthy and were discharged on the 6th day. She remained in remission after discharge; PSL was discontinued and remission was maintained only with 5-ASA. There are only a few studies regarding the development of ulcerative colitis during pregnancy , so further research is necessary; however, good disease control can be achieved for both the mother and baby by careful cooperation with the physicians. [Adv Obstet Gynecol, 72 (1) : 29-33, 2020 (R2.2)]