Abdominal Imaging in pregnancy (maternal and foetal risks)

Area of Science:

• Gastroenterology
• Radiology
• Obstetrics

Background:

• Imaging is crucial for diagnosing inflammatory bowel diseases (IBD).
• Safety concerns regarding imaging modalities for pregnant and lactating women often lead to avoidance of necessary diagnostic tests.
• Disruption of breastfeeding is also a concern.

Purpose of the Study:

• To review the safety and utility of various imaging techniques for diagnosing inflammatory bowel diseases in pregnant and lactating women.
• To provide guidance on selecting appropriate imaging modalities to minimize risks to mother and infant.

Main Methods:

• Review of current literature on imaging in inflammatory bowel disease during pregnancy and lactation.
• Discussion of the risks and benefits of ultrasonography, magnetic resonance imaging (MRI), and computed tomography (CT).

Main Results:

• Ultrasonography and MRI without gadolinium are the preferred imaging techniques for pregnant patients due to the absence of ionizing radiation.
• MRI contrast agent gadolinium safety in pregnancy is uncertain, necessitating its avoidance.
• Intestinal ultrasound and MRI without gadolinium can effectively characterize complications like bowel obstruction and collections.
• CT involves ionizing radiation and should be reserved for situations where ultrasound and MRI are unavailable or inadequate.

Conclusions:

• Safe and effective imaging options exist for pregnant and lactating women with inflammatory bowel disease.
• Ultrasonography and MRI without gadolinium are recommended as first-line imaging modalities.
• Careful consideration of risks versus benefits is essential when selecting imaging techniques for this patient population.