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[Acute pancreatitis and pregnancy]
Minerva Ginecologica
|December 1, 1993
Summary
Pregnancy-associated acute pancreatitis, often caused by gallstones or hypertriglyceridemia, requires prompt diagnosis and management. Timely medical or surgical intervention improves outcomes for both mother and fetus.
Area of Science:
- Obstetrics and Gynecology
- Gastroenterology
- Internal Medicine
Background:
- Acute pancreatitis during pregnancy is rare but serious, with potential complications for mother and fetus.
- Common etiologies include gallstones, hyperlipidemia, and hypertriglyceridemia, typically manifesting in the third trimester.
Observation:
- Two cases of acute pancreatitis in pregnancy are presented, both with biliary tract obstruction as the cause.
- Symptoms like vomiting and abdominal pain are nonspecific, necessitating differential diagnosis.
- Diagnosis relies on elevated serum amylase and lipase levels, confirmed by ultrasonography.
Findings:
- Medical management involves symptomatic treatment, low-fat diet, and parenteral nutrition if triglyceride levels exceed 28 mmol/L.
- Surgical intervention is reserved for obstructive biliary pathology, ideally performed in the third trimester or postpartum.
- Both medically managed patients delivered healthy infants at term.
Implications:
- Prompt diagnosis and appropriate management are crucial for improving the prognosis of pregnancy-associated acute pancreatitis.
- This condition carries significant maternal and fetal mortality rates due to complications like shock, coagulopathy, respiratory insufficiency, and preterm delivery.