Acute pancreatitis in pregnancy.

Area of Science:

• Obstetrics and Gynecology
• Gastroenterology
• Critical Care Medicine

Background:

• Pancreatitis during pregnancy presents significant maternal-fetal risks.
• Distinguishing risks between mild and severe pancreatitis cases is crucial for management.

Purpose of the Study:

• To compare maternal-fetal outcomes in pregnancies complicated by mild versus severe acute pancreatitis.
• To identify etiological factors and clinical characteristics differentiating severe from mild pancreatitis in pregnancy.

Main Methods:

• Retrospective observational study of 69 pregnancies (18 severe, 51 mild acute pancreatitis).
• Data collected from January 1999 to December 2009 at a university referral hospital.
• Analysis included demographics, clinical/laboratory data, and maternal/fetal outcomes.

Main Results:

• Severe acute pancreatitis occurred later in gestation (third trimester) compared to mild cases.
• Severe hypertriglyceridemia was the primary cause of severe pancreatitis (OR 20.7), while biliary disease caused mild pancreatitis (OR 7.3).
• Fetal outcomes differed: abortions/preterm infants in mild cases, fetal death/stillbirth in severe cases.

Conclusions:

• Hyperlipidemic pancreatitis and biliary pancreatitis are key etiological factors for severe and mild disease, respectively.
• Severe acute pancreatitis in pregnancy, particularly in the third trimester, is associated with a critical condition and increased risk of intrauterine fetal death.