Pancreatitis in pregnancy: etiology, diagnosis, treatment, and outcomes

Mali, Padmavathi

doi:10.1016/s1499-3872(16)60075-9

Cited by 52 publications

(33 citation statements)

References 24 publications

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“…In our study, most patients had APIP onset during the third trimester (68%) but we also had 2 and 31% had APIP during the first and the second trimester. This proportion was similar from previous studies reporting that most APIP occurred in the third trimester [ 18 , 19 ]. The underlying mechanism is probably due to the compression to the pancreas and gallbladder by the enlarging uterus, as well as changing in steroids that directly affect gallbladder function [ 20 ].…”

Section: Discussionsupporting

confidence: 91%

Clinical characteristics of acute pancreatitis in pregnancy: experience based on 121 cases

Luo

Zen

et al. 2017

Arch Gynecol Obstet

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PurposeAcute pancreatitis in pregnancy (APIP) is a rare condition; however, it markedly affects maternal and fetal health. This study aimed to describe the types, clinical characteristics, mortality, and the safety and necessity of gestation termination of acute pancreatitis in pregnancy (APIP).MethodsWe retrospectively reviewed 121 APIP cases in the Gastroenterology Department of The First Affiliated Hospital of Nanchang University. APIP diagnosis were based on 2012 Atlanta Criteria. The correlation between APIP types, severity, biochemical parameters and mortality was analyzed.ResultsThe most common symptoms for APIP were abdominal pain (86.8%) and vomiting (73.6%). The most common causes for APIP were gallstone (36.4%) and hypertriglyceridemia (32.2%) and hypertriglyceridemic APIP was correlated with a higher rate for local complication (P = 0.012). Serum calcium level was negatively correlated with the severity of APIP (P < 0.01). The overall maternal and fetal mortality rate were 3.3% (4/121) and 11.6% (14/121), respectively. The severity of APIP was significantly correlated with higher risks for maternal and fetal death (P < 0.01). 72.7% of moderate-to-severe APIP patients underwent Cesarean section to terminate gestation safely.ConclusionThe most common causes of APIP were gallstone and hypertriglyceridemia. Lower level of serum calcium could be used as an indicator for the severity of the APIP. The severity of APIP was associated with higher risk for neonate asphyxia, and maternal and fetal death.

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Section: Discussionsupporting

confidence: 91%

Clinical characteristics of acute pancreatitis in pregnancy: experience based on 121 cases

Luo

Zen

et al. 2017

Arch Gynecol Obstet

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“…MRI also offers improved visualization of the pancreas, leading to improved diagnosis of pancreatitis . Gallstone pancreatitis remains the leading cause of acute pancreatitis during pregnancy.…”

Section: Indications For Mri In Pregnancymentioning

confidence: 99%

“…Complications that may be evaluated using MRI include pancreatic pseudocysts, pancreatic necrosis, and splenic vein thrombosis. MRI also offers improved visualization of the pancreas, leading to improved diagnosis of pancreatitis . Gallstone pancreatitis remains the leading cause of acute pancreatitis during pregnancy.…”

Section: Indications For Mri In Pregnancymentioning

confidence: 99%

“…43,44 MRI also offers improved visualization of the pancreas, leading to improved diagnosis of pancreatitis. 45 Gallstone pancreatitis remains the leading cause of acute pancreatitis during pregnancy. Patients typically present with nausea, vomiting, and epigastric abdominal pain, and may show elevated lipase on laboratory analysis.…”

Section: Indications For Mri In Pregnancymentioning

confidence: 99%

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MRI in pregnancy: Indications and practical considerations

Mervak

Altun

McGinty

et al. 2019

Magnetic Resonance Imaging

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There is a constantly evolving knowledgebase regarding the safety of MRI in pregnant patients, as well as the safety of gadolinium administration, given potential fetal risks. This review provides an overview of national and international recommendations for patient screening and safety by trimester, evaluates the most recent literature regarding administration of gadolinium in pregnant patients, and discusses technical requirements when imaging pregnant patients. A protocol for imaging pregnant patients is provided, and multiple common indications for MRI in pregnancy are discussed. Level of Evidence 5. Technical Efficacy Stage 5. J. Magn. Reson. Imaging 2019;49:621–631.

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“…Esta ocurre principalmente en multíparas, siendo el tercer trimestre el período que alberga más de 50% de los casos 2 .La etiología biliar es el responsable de 56 a 70% de PAE. Esta ocurre por el ambiente microlitogénico que se genera a medida que avanza la gestación, por un aumento de la secreción de colesterol biliar con sobresaturación de la bilis, aumento del volumen vesicular, y una reducción en la tasa de su vaciamiento, aumentando su ectasia, generando un ambiente idóneo para la cristalización de colesterol y formación de cálculos[1][2][3] .La segunda etiología mas frecuente, a contar del segundo trimestre, es la hipertrigliceridemia. Esta se relaciona con el incremento de sus niveles a medida que avanza el embarazo por disminución de la actividad de la lipoproteína lipasa 2,3 .…”

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Pancreatitis aguda por hipercalcemia en el embarazo. Caso clínico

Arnold

Martínez²,

Oksenberg

et al. 2019

Rev. méd. Chile

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Acute pancreatitis due to hypercalcemia during pregnancy. Report of one case Acute pancreatitis during pregnancy is uncommon and usually associated with gallstones. However other etiologies must be considered. We report a 24 years old woman with a 32 weeks pregnancy consulting for abdominal pain, nausea and vomiting. She had elevated lipase and amylase levels, a corrected serum calcium of 13.1 mg/dl and a serum phosphate of 1.6 mg/dl. A magnetic resonance colangiopancreatography showed an enlarged pancreas with inflammatory changes and a normal Wirsung duct. A parathyroid nodule was found on cervical ultrasonography. The patient was treated initially with cinacalcet with partial response. A parathyroidectomy was performed at 39 weeks of pregnancy with a good maternal and fetal evolution. (Rev Med Chile 2019; 147: 1078-1081

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Pancreatitis in pregnancy: etiology, diagnosis, treatment, and outcomes

Cited by 52 publications

References 24 publications

Clinical characteristics of acute pancreatitis in pregnancy: experience based on 121 cases

Clinical characteristics of acute pancreatitis in pregnancy: experience based on 121 cases

MRI in pregnancy: Indications and practical considerations

Pancreatitis aguda por hipercalcemia en el embarazo. Caso clínico

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