Acute pancreatitis in pregnancy

Discuss the course of acute pancreatitis in pregnant patients and demonstrate that most attacks of pancreatitis in pregnancy are mild.

This article is a retrospective case series study. Eight patients with acute pancreatitis during pregnancy were seen in referral-based obstetric practice at our department in the last 5 years. Five of them had either gallstones or hyperlipidemia. Two patients had both gallstones and hyperlipidemia. One patient was lost to follow-up at 33 weeks gestation. The others were followed at least one month post-partum. Conservative treatment was instituted for pancreatitis and a fat-restricted diet was instituted for hyperlipidemia.

There was no maternal mortality and only one fetal death. Acute pancreatitis occurred in both primipara and multipara patients. Preterm labor or preeclampsia may occur in pregnancy complicated by acute pancreatitis. Most patients experience relief from the pancreatitis soon after delivery. Two patients underwent cesarean section, one was due to fetal distress and the other was elective.

Early diagnosis and treatment is of utmost importance. Gallstones and/or hyperlipidemia seems to have a specific link with acute pancreatitis in pregnancy. Although acute pancreatitis is a rare complication of pregnancy, we present evidence that both maternal and fetal mortality can be minimized if appropriately treated.