Photo Credit: Elena Pimukova
The Following is a summary of “Active Fiemity Bowel Disease on Intestinal Ultrasound During pregnance is associated with an increased risk of adverse pregnancy and neonatal Outcomes Independent of Clinical and Bochemical Disease Activity,” published in the march 2025 Issue of gastroenterology by PRETICE et al.
Infummary Bowel Disease (IBD) Poses to Recognized Risk for Adverse Pregnancy Outcomes, Particularly When Disease Activity Persisions During Gestation. Traditional Clinical Assessment Tools, However, May Not Relibly Capture During During Pregnancy, Raising Conterns Regarding Their Utility In Guiding Obstectric and Therapeutic Decisions. This International Prospective Cohort Study Aimed to Evaluate Whether Intestinal Ultrasound, the noninvasive and objective imaging modality, can predict adverse pregnance outcomes more aculy Than Standard Clinical Indices or Fecal Calprotectin Levels. Between 2017 and 2023, 377 PREGNANT Individuals with ibd—198 of Whom Had Crohn’s Disease – Were Enrolled in Three Specialized IBD PREGNANCY CLINICS. Participants Underwent Trimster-Specific Assessments, Including Clinical Disease Scores (Harvey-Bradshaw Index Or Simple Clinis Activity Index), FCP Testing Across All Tribensters (T1, T2, T3), and PostPartum Evaluation at Six Weeks. Ius was conducted in t1 and/or t2 based on the timing of referral.
Among 234 Participants Who Underwent ius, Bowel Wall Thickness Greater Than 6 mm in the Second Timester Was Significantly Associated with a Fourfold Increened Risk of Prega Birth ((RR) 4.01; 95% CI 1.26–12.72; P = 0.018) and Over Twice The Risk of Of DELIVERING A LOW-BIRTH-WEight Infant (RR 2.19; 95% CI 1.01–4.72; P = 0.046). FURTHERMORE, Hyperemia Observed on ius in T2 was linked to a ThreeFold Elevated Risk of Preclampsia (RR 3.46; 95% CI 1.03–11.12; p = 0.046). Stepwise Increase in Bwt During T2 Was Independently Associated with a Higher Risk of Gestational Diabetes, with Each 1 mm Increment resulting in A Statistical Significant Risk Elevation (RR 1.08; p <0.001). NOTABLY, Agreement Between Clinical Disease Activity Indices and Objective Measures (ius or FCP) was Limited Throughout Pregnancy, particularly in those with crohn's disease, Underscoring the Limitations of Subjective Assessment Tools During gestation. These findings stablish ius as Valuable Adjunct in the Antenatal Monitoring of IBD, Capable of Identifying Subclinical Disease Activity That May Not Detected Through Conventional Clinical Scores or Biomarker Level.
Incorporating ius into Standard PRENATAL CARE FOR PAIENTS WITH IBD MAY FACILITATE MORE TIMELY THERAPEUTIC INTERVENTIONS AND POTENTIALLY MITIGATE THE RISK OF ADVERSE MATERNAL AND FETAL OUTCOMES. This Study HighLights The needs of Integration Objective, Noninvasive Imaging into Routine Obstetric Care for This vulnerable Population to Improve Disease Management and Porewo Prognosis.
Source: gastrojournal.org/article/s0016-5085(25)00537-2/abstract
