Laboratory

Regarding possible diagnostic means to monitor the disease and for early recognition of recrudescences, the role of laboratory parameters is limited, as they are undermined by poor reliability of values during pregnancy. Constant physiological modification, connected with hemodilution, is necessary for some parameters that do not present suitable specificity to monitor pregnant women with IBD. These physiological changes include reduction of haemoglobin of about 1 g/dl, reduction of blood iron level, a two- to three-fold increase in erythrocyte sedimentation rate (ESR), reduction of about 1 g/dl of blood albumin and an increase of alkaline phosphatase of about 1.5% . As these parameters may be analogously modified even during the early stages of IBD relapse, they should not be used as diagnostic tools during pregnancy to avoid false positivities, or at least they should always be set in a wider clinical evaluation. For example, if a pregnant patient with CD shows good health conditions but her hematocrit decreased and her ESR increased, she probably is in a quiescent stage of the disease and does not need further examination. On the contrary, a pregnant patient showing ingravescent diarrhoea, abdominal pain and highly altered laboratory parameters does require further diagnostic examination, possibly including an endo-scopic evaluation.

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