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In Belgium the product is sold under the name "Rilatine" and in Brazil and Portugal as "Ritalina".
To report a case Celiac disease (gluten enteropathy) diagnosed during the investigation of recurrent abortion who was delivered term pregnancy following appropriate management. Although Celiac disease is a malabsorption syndrome,it may lead to serious maternal and fetal complications because of systemic effects of the disease However,a successful pregnancy outcome is possible when pregestational diagnosis is made and proper management of the disease during pregnancy is achieved. Celiac disease (also known as gluten sensitive enteropathy) is a prototype a malabsorbtive disease due to loss of the absorbtive area of the small intestines.
Another subject of importance,is that mothers diagnosed with celiac disease have a higher risk of carrying intrauterine growth restricted fetuses and giving birth to newborns with low birth weight.Basically this is related to malabsorbtion caused by recurrent attacks of diarrhea,gradually resulting in malnutrition.
However,as demonstrated with this case,early diagnosis and appropriate therapy help reduce these complications.

Small bowel mucosal inflamation in reticulin or gliadin antibody positive patients without villous atrophy.
Female fertility, obstetrics and gynaecological history in coeliac disease: a case control study.
Coeliac disease in the father and risk of adverse pregnancy outcome: A population-based cohort study.
After diagnosis the patient concieved (aided by intruterin insemination) for the third time.The patient was followed up with a routine antenatal programme, and supplemented with iron,folic acid and multivitamins.
Bearing this in mind Ciacci et al,showed that untreated celiac sufferers had higher rates of intrauterine growth restriction and low birth weight compared to those who recieved appropriate treatment (8).Our case gave birth to a male newborn weighing 2990grams which showed no sign of intrauterine growth restriction (between 10-15 percentiles).
Celiac disease,as we mentioned earlier is a prototype for malabsorbtion syndromes,caused by hypersensitivity to gluten.It is crucial for these patients and their fetuses to recieve the daily amount of nutrition the increased metabolism requires during pregnancy.

Infertility is also seen with a higher incidence in celiac sufferers when compared to the uneffected population(5).
Research shows that the defiency of certain essential trace elements and vitamins lead to considerable pregnancy complications and reproductive problems. Those that concieve (spontaneously or aided by assisted reproductive techniques),show a higher rate of recurrent miscarriages, intrauterine growth restriction,and problems like preeclampsia in comparison with the uneffected population(6). This case report aims to discuss how gluten sensitivity affected a patients fertility and pregnancy outcome.

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