Hypertriglyceridemia induced acute pancreatitis in pregnancy: Learning experiences and challenges of a Case report

Athar, Sufia; Ramawat, Joohi; Aziz, Mohammad; Boama, Vincent

doi:10.29328/journal.cjog.1001017

Cited by 2 publications

(3 citation statements)

References 16 publications

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“…Lipid levels in the first trimester are usually the same as pre-pregnancy and change significantly in the second and third trimesters [ 29 ]. There is usually a two to four-fold increase in plasma triglyceride level during pregnancy [ 30 ], which is normally well-tolerated (< 300 mg/dL or 3.3 mmol/L) and does not affect the mother or fetus [ 31 ], but in some high-risk women, triglyceride level may increase to an abnormally high level (more than 95 th centile for the age) or even severe level (> 1000 mg/dL or 11.3 mmol/L) [ 32 ]. Moreover, previous studies demonstrated that women from East and South Asia, including China, have higher levels of TG, TC and LDL than western populations [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…Timely treatment of patients who are found to have gallstones can help prevent APIP. Patients with hyperlipidemia should stop taking lipid-lowering drugs during pregnancy owing to the lack of definitive evidence of their safety during pregnancy [ 32 ]. However, they should be fully informed of the possible complications and treatment methods during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

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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%

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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“…Hyperlipidemia (HL) AP in pregnancy has been reported to be associated with a maternal mortality rate of ~20% (6). HLAP can cause serious complications, such as fetal distress, intrauterine death, maternal multiple organ failure, abdominal compartment syndrome and pancreatic encephalopathy, when not treated in a timely manner (7).…”

Section: Treatment and Diagnosis Of Hyperlipidemia Acute Pancreatitis...mentioning

confidence: 99%

Treatment and diagnosis of hyperlipidemia acute pancreatitis in pregnancy associated with pre‑pregnancy obesity and diabetes: A case report

Cao,

Ni,

Gan

et al. 2023

Exp Ther Med

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Hyperlipidemia acute pancreatitis (HLAP) is a specific type of pancreatitis mainly caused by elevated serum triglyceride (TG) levels. Therefore, knowledge of patients' medical history is crucial to the identification of those at high risk of HLAP. Diabetes and obesity are associated with high levels of triglycerides, a risk factor for the development of HLAP, which should be controlled before pregnancy. Moreover, HLAP is associated with additional diagnostic and management challenges related to hyperlipidemia (HL) and pregnancy. HLAP during pregnancy has a rapid onset and rapid progression, and complications are more likely to damage the function of multiple organs. HLAP is more common after 28 weeks of pregnancy, the cause is mostly high TG and the serum TG of the patient is often >1,000 mg/d1. Clinicians should be alert to the occurrence of server acute pancreatitis (AP). Therefore, clinicians need to identify and implement effective treatment in a timely manner to control the progression of HLAP during pregnancy and improve pregnancy outcomes. The present study reported the case of a 26-year-old pregnant patient who was hospitalized for epigastric pain at 35 weeks and 2 days of gestation. Medical and family history reported previous diagnoses of diabetes and obesity (weight before pregnancy, 103 kg; BMI, 36.40 kg/m 2 ). Laboratory tests demonstrated high levels of lipase and amylase, a notable systemic inflammatory response, HL, coagulopathy, hypoproteinemia and hyperglycemia. Abdominal ultrasonography demonstrated a hypoechoic pancreatic head. A clinical diagnosis of AP was confirmed using CT scanning. Initial interventions for HLAP included aggressive intravenous hydration, bowel rest, pain control and a combination of heparin and insulin. Lipid-lowering agents were administered to reduce serum lipid levels. Hemoperfusion and continuous renal replacement therapy were also used to rapidly counteract the elevated lipid levels. Antibiotics were administered in the present case because inflammatory markers such as leukocytes, neutrophils and C-reactive protein were elevated. The patient and newborn were discharged 11 days after hospitalization, with an improvement in maternal clinical health and the infant was healthy. When evaluating pregnant patients with pre-obesity and diabetes presenting with abdominal pain, obstetricians should consider HLAP. Timely diagnosis and multi-team precision treatment are effective for good outcomes for mother and baby.

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Hypertriglyceridemia induced acute pancreatitis in pregnancy: Learning experiences and challenges of a Case report

Cited by 2 publications

References 16 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

Treatment and diagnosis of hyperlipidemia acute pancreatitis in pregnancy associated with pre‑pregnancy obesity and diabetes: A case report

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