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Hypertriglyceridemia induced acute pancreatitis in pregnancy: a case report
Sagar Mandal1,2, Astha Chhantyal1, Manvi Mukherjee3
1Tribhuwan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal.
Introduction And Importance:
Various metabolic and physiologic changes that occur during pregnancy can sometimes lead to severe hypertriglyceridemia during pregnancy. The resultant hypertriglyceridemia may lead to acute pancreatitis in pregnancy, which even being rare poses significant health risks to both the child and the mother.
Presentation Of Case:
A 26-year-old female, G4P1L1A2 at 36 weeks and 3 days of gestation, presented with an acute onset of abdominal pain in the epigastric region and multiple episodes of vomiting. With a diagnosis of acute pancreatitis, she was admitted to the intensive care unit for the multidisciplinary approach with a plan to reduce the triglyceride (TG) levels rapidly. The woman was finally discharged against medical advice with oral antibiotics.
Case Discussion:
Hypertriglyceridemia-induced acute pancreatitis in a pregnancy is a rare occurrence, usually seen in females with prior hyperlipidemia and with genetic predisposition, which is associated with significant morbidity and mortality. Our patient presented with TG levels above 1500 mg/dL. The favored treatment modality in our case was insulin therapy and omega-3 fatty acids. Baby was delivered through an elective caesarean section.
Conclusion:
Proper treatment modality according to the TG levels of the patient, along with proper continuous monitoring of both the mother and the baby, is very much essential. Injectable insulin and diet modification are equally important. The mode of delivery is assessed based on various parameters of fetal maturity and maternal risk factors.
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