Особливості клінічної симптоматики та можливості ранньої діагностики гострого панкреатиту у вагітних

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Traditional methods of diagnosing acute pancreatitis (AP) in pregnant women do not differ from diagnostic criteria in the non-pregnant population. Instead, physiological changes during pregnancy and the similarity of clinical manifestations of the disease with typical pregnancy complications are associated with difficulties in diagnosis, late diagnosis, and deterioration of treatment results. Аim - to analyze the diagnostic value of the criteria for diagnosing AP in pregnant women. Materials and methods. 123 pregnant women aged 18 to 42 years with a gestation period of 12 to 37 weeks (on average - 21.95±8.81 weeks) with AP were examined: I (control) group - 62 pregnant women, using traditional methods of treatment and diagnosis, and II (main) group - 61 pregnant women, using the developed diagnostic and treatment algorithm. Statistical data processing was carried out using the SPSS 21 program. Results. Our results show that the triad of clinical symptoms of AP (typical "pancreatic" pain, nausea and vomiting, paralytic intestinal obstruction) are found in only 29% of pregnant women. The frequency of painless forms of AP is 29.1%. The diagnostic sensitivity and specificity of blood leucocytosis for AP in pregnant women is 75.8% and 54.8%, an increase in the level of serum amylase 3 times about the upper limit of average - 74.2% and 68.7%, lipase - 77.4% and 90.3%, respectively. 48.4% of pregnant women had sonographic changes characteristic of AP within the first day from the moment of disease manifestation. In the group ІІ, when applying the diagnostic and treatment algorithm, 100% of patients had acute pancreatitis at an early stag Conclusions. Our results indicate that early diagnosis of AP in pregnant women using generally accepted diagnostic criteria is possible in no more than 48.8% of cases, which suggests the need to improve early diagnosis of the disease in this category of patients. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.