Asked to choose between a flare and a JAK inhibitor in the third trimester, Mette Julsgaard answers in two words: active disease.

Part two picks up where aspirin for preeclampsia ended and moves to the situations that actually keep clinicians awake. Mette Julsgaard, Associate Professor at Aarhus University Hospital and a co-author of the 2025 global consensus statement on pregnancy in IBD, takes Pradeep Mundre through starting upadacitinib at 28 weeks when nothing else was left, why thiopurines should never be initiated in pregnancy even though they can be continued, and how to manage acute severe ulcerative colitis without letting surgery drift.

Also here: why active perianal disease and a pouch push you towards caesarean section and why BCG waits six months but rotavirus does not.

Part one covers fertility, preconception and the full drug run-through, be sure to listen to it, before you start with this episode.

Further reading:

• Rotavirus, the Canadian study