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Acute pancreatitis in pregnancy
K D Ramin1, S M Ramin, S D Richey
1Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, USA.
American Journal of Obstetrics and Gynecology
|July 1, 1995
Summary
Acute pancreatitis in pregnancy, often linked to biliary disease, can be managed effectively with prompt supportive care and surgery. While maternal outcomes are generally favorable, severe cases may lead to preterm delivery and fetal death.
Area of Science:
- Obstetrics and Gynecology
- Gastroenterology
- Perinatal Medicine
Background:
- Acute pancreatitis is a rare but serious complication during pregnancy.
- Understanding its causes and impact on maternal and fetal health is crucial.
Purpose of the Study:
- To determine the etiology of acute pancreatitis in pregnancy.
- To describe the natural history and management of this condition.
- To evaluate its effects on maternal and perinatal outcomes.
Main Methods:
- A retrospective review of 43 pregnant women diagnosed with acute pancreatitis over a decade.
- Analysis of patient presentation, diagnostic methods, treatment strategies, and outcomes.
Main Results:
- The incidence was 1 in 3333 pregnancies, with biliary disease being the most common associated factor (68%).
- Supportive therapy (bowel rest, hydration, antibiotics) was effective for all patients.
- Surgical intervention (cholecystectomy) was performed in 20 women (18 antepartum, 2 postpartum).
- Maternal outcomes were generally favorable, with most term deliveries resulting in healthy infants.
- However, preterm delivery occurred in six infants, with two stillbirths and one neonatal death.
Conclusions:
- Biliary tract disease is a frequent cause of acute pancreatitis in pregnant individuals.
- Prompt hospitalization, supportive care, and timely surgical intervention can significantly reduce maternal and fetal morbidity and mortality.
- Severe pancreatitis poses a risk for preterm birth and fetal demise.