Acute Pancreatitis in Pregnancy

Abstract

Acute pancreatitis (AP) in pregnancy is rare, but a serious event occurring between 1 in 1000 and 1 in 12,000 pregnancies. The spectrum of AP in pregnancy varies from mild to severe pancreatitis. Severe pancreatitis might be associated with multiple organ failure, pancreatic abscess, pseudocyst, and necrosis. The commonest cause for AP in pregnancy is gallstones (60–100 %). Signs and symptoms of gallbladder disease precede acute pancreatitis. The diagnosis is usually difficult due to physiological changes in pregnancy. The clinical features, laboratory investigations like serum amylase and lipase and imaging techniques such as ultrasonography and magnetic resonance cholangiopancreatography, help in diagnosis. Mild AP in pregnancy is usually managed conservatively while severe AP requires management in the intensive care unit. Therapeutic modalities like endoscopic sphincterotomy, biliary stenting, and laparoscopic cholecystectomy are major milestones in management of severe acute pancreatitis in pregnancy. When properly managed, AP in pregnancy is not associated with bad prognosis as in the past.