Acute and chronic pancreatitis in pregnancy

O’heney, Josie; Barnett, Rebecca; MacSwan, Ruth M; Rasheed, Ashraf

doi:10.1111/tog.12725

Cited by 7 publications

(8 citation statements)

References 39 publications

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“…The management of APIP is complicated by the decision-making regarding the timing and route of termination of pregnancy (induction of labor or cesarean section or vaginal delivery) [ 39 ]. Pregnancy termination can also be regarded as a key to achieve cure of AP [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Acute pancreatitis in pregnancy: a 10-year, multi-center, retrospective study in Beijing

Zhang

Wang

Chen

et al. 2022

BMC Pregnancy Childbirth

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Objective Acute pancreatitis in pregnancy (APIP) is a rare and serious complication during pregnancy. It has acute onset and is difficult to diagnose and treat. The aim of the present study was to describe the etiology, clinical manifestations, and maternofetal outcomes of APIP. Methods We retrospectively reviewed 32 pregnant women who were treated at three tertiary care hospitals in Beijing, China. The correlation between the causes of APIP, severity, laboratory indices, and outcomes was analyzed. Results The most common causes of APIP were hypertriglyceridemia (56.2%,18/32) and gallstones (28.1%, 9/32). Hypertriglyceridemia-induced APIP was associated with a higher rate of severe acute pancreatitis (P = 0.025). Serum level of triglycerides showed a positive correlation with the severity of APIP (P = 0.039). The most frequent presentation of APIP was abdominal pain (93.7%, 30/32). There were no maternal or fetal deaths in our study. Apgar scores at 1 min, 5 min, and 10 min of the premature neonates was correlated with the severity of APIP of the mother (P = 0.022; 0.002; 0.002). Conclusion High level of triglycerides may serve as a useful marker of the severity of APIP. The severity of APIP was associated with higher risk of neonate asphyxia. Appropriate timing of termination of pregnancy is a key imperative for APIP patients.

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Section: Discussionmentioning

confidence: 99%

Acute pancreatitis in pregnancy: a 10-year, multi-center, retrospective study in Beijing

Zhang

Wang

Chen

et al. 2022

BMC Pregnancy Childbirth

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“…Using the Naranjo scale, pancreatitis caused by the Pfizer vaccine in this patient scored 5 "probable" [12]. The pregnancy was not assumed to be the cause of pancreatitis as an association between pregnancy and pancreatitis is very rare [13]. Eddy et al [14] found that acute pancreatitis occurs in approximately 3 out of 10,000 pregnancies, while Sun et al [15] demonstrated an increase in the incidence of preterm delivery in pregnant women with pancreatitis, as was seen in the present case report.…”

Section: Discussionmentioning

confidence: 92%

Acute pancreatitis in pregnancy following COVID-19 vaccine: a case report

et al. 2022

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Background Since the approval of the Pfizer–BioNTech (BNT162b2) mRNA vaccine for COVID-19 infection, a few adverse effects have been reported. Acute pancreatitis has been reported in a few patients. However, there is currently no research showing a direct relationship between the vaccine and acute pancreatitis. Here, we report a case of acute pancreatitis following Pfizer vaccination in a young healthy pregnant woman without any known risk factors. To our knowledge, this is the first case report of possible vaccine-induced pancreatitis in a pregnant woman. Case presentation The patient, a 24-year-old South-Asian female, at 31 weeks of gestation, presented with severe epigastric pain radiating to the back and worsening on lying supine, associated with nausea and vomiting. She was diagnosed with acute pancreatitis with a serum lipase level of 4376 U/L and an ultrasound showing features of pancreatitis. The patient received her first dose of the Pfizer vaccine 1 week prior to these symptoms. Detailed evaluation did not show any etiological cause of pancreatitis. The patient had a spontaneous vaginal delivery and the baby was shifted to the neonatal intensive care unit in a stable condition. A computed tomography scan postpartum (day 2) demonstrated acute interstitial edematous pancreatitis. The patient was managed conservatively in the intensive care unit and discharged home in a stable condition. Conclusion This report highlights the importance of a detailed history and evaluation, and the close monitoring of any patient presenting with abdominal pain after vaccination. Acute pancreatitis can be fatal if not picked up early.

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“…Acute pancreatitis is a rare complication in pregnancy with an incidence of 1/1000 to 3/10000 75 . It is more commonly experienced in the third trimester in multiparous women.…”

Section: Impact Of Elevated Lipids On Pregnancy Complicationsmentioning

confidence: 99%

“…Hypertriglyceridaemia‐induced acute pancreatitis (HIAP) accounts for up to 58% of cases in pregnancy 78 . Hypertriglyceridaemia is the third commonest cause of acute pancreatitis in pregnancy 75 . HIAP is associated with increased rates of pre‐eclampsia, hyperviscosity syndrome, bleeding, heart failure, fetal demise (up to 23.7%), neonatal death (up to 7.5%) and a maternal mortality rate of up to 20% 77,79 …”

Section: Impact Of Elevated Lipids On Pregnancy Complicationsmentioning

confidence: 99%

Hyperlipidaemia and severe hypertriglyceridaemia in pregnancy

Bashir

Navti

Ahmed

et al. 2023

The Obstetric & Gynaecologis

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Lipid and triglyceride levels increase in pregnancy and do not pose problems for most women. However, pregnancy-specific factors and genetic aberrations, especially mutations, may result in supraphysiological hypercholesterolaemia (HC) and severe hypertriglyceridaemia (sHTG). HC and sHTG are associated with complications in pregnancy, including acute pancreatitis, hyperviscosity syndrome and pre-eclampsia. Abnormally high levels of lipids and triglycerides also affect fetal growth and the onset of gestational diabetes. The clinical presentation and diagnosis of HC and sHTG are varied. Management options include lifestyle and dietary restriction/ modification, omega-3, bile-acid sequestrants, fenofibrate, statins and plasmapheresis. Learning objectivesTo understand the physiological changes that occur in lipids in pregnancy and how these are modulated. To appreciate the importance of severe HC and HTG in pregnancy, including their effects on maternal morbidity and mortality. To understand the various approaches to management and the importance of multidisciplinary management. Ethical issuesShould every woman be screened for HTG and HC during pregnancy? How safe are statins and other treatments for lipid disorders in pregnancy? Should women with very severe HTG be discouraged from getting pregnant?

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Acute and chronic pancreatitis in pregnancy

Cited by 7 publications

References 39 publications

Acute pancreatitis in pregnancy: a 10-year, multi-center, retrospective study in Beijing

Acute pancreatitis in pregnancy: a 10-year, multi-center, retrospective study in Beijing

Acute pancreatitis in pregnancy following COVID-19 vaccine: a case report

Hyperlipidaemia and severe hypertriglyceridaemia in pregnancy

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