Pancreatitis in Pregnancy

Abstract

Objective To estimate the incidence, etiology and complications of pancreatitis in pregnancy and identify factors associated with adverse outcomes. Methods Chart review of all patients diagnosed with pancreatitis and pregnancy from 1992–2001 at 15 participating hospitals. Information was collected on presentation, management and outcome, along with the number of deliveries at each hospital. Results During the 10 years of the study, 101 cases of pancreatitis occurred among 305,101 deliveries, yielding an incidence of one in 3,021 (.03%). There were no maternal deaths; perinatal mortality was 3.6%. Eighty-nine women had acute pancreatitis and twelve women had chronic pancreatitis. The majority (66%) of cases of acute pancreatitis were biliary in origin, and they were associated with better outcomes than non-biliary etiologies. Cases of gallstone pancreatitis that received surgical or endoscopic intervention during pregnancy had lower rates of preterm delivery and recurrence than those that were conservatively managed, but this difference was not significant (p=0.2). Alcohol was responsible for 12.3% of acute pancreatitis and 58% of chronic pancreatitis and was associated with increased rates of recurrence and preterm delivery. A calcium level, triglycerides or both was not obtained in half of cases identified as idiopathic. Conclusion Pancreatitis is a rare event in pregnancy, occurring in approximately 3 in 10,000 pregnancies. While it is most often acute and related to gallstones, non-biliary causes should be sought, as they are associated with worse outcomes.

The Liver in Pregnancy

“…Acute pancreatitis may complicate pregnancy [129]. The serum amylase and lipase levels are normal during pregnancy, so abnormal values warrant attention [130].…”

“…The serum amylase and lipase levels are normal during pregnancy, so abnormal values warrant attention [130]. Pancreatitis usually occurs in the setting of cholelithiasis [129], and gallstones should be sought in any affected patient. Patients with pancreatitis or symptomatic cholelithiasis during pregnancy may be managed by endoscopic retrograde cholangiopancreatography with sphincterotomy [131,132].…”

Experience of Treatment of Pregnant Women With Acute Abdomen

“…Распространенность острого панкреатита у бе-ременных колеблется от 1:1000 до 1:12000, повы-шаясь со сроком гестации и числом родов в анам-незе [20,21]. В 24% наблюдений панкреатит разви-вается в I триместре беременно сти, в 33% -во II и в 43% -в III триместре беременности.…”

Etiology of acute pancreatitis

“…Abdominal ultrasound and endoscopic ultrasound are ideal imaging techniques for diagnosing disease because they have no radiation risk. In the last decades the outcome of acute pancreatitis in pregnancy is much better, and perinatal mortality is less than 5% [98].…”