Clinical analysis of diagnosis and treatment of acute pancreatitis in pregnancy

Abstract

Objective To explore the etiology,mechanism,clinical features,diagnosis,therapy and prevention of acute pancreatitis in pregnancy(APIP).Methods The clinical data of 63 cases of APIP treated in our hospital from January 1996 to December 2006 were retrospectively analyzed.Results Among the 63 cases of APIP,there were 43 (68.25%) cases of mild acute pancreatitis (MAP) and 20 (31.75%)cases of severe acute pancreatitis (SAP).Thirty-seven (58.73%) patients had gallstone or chronic cholecystitis and 19 (30.16%) had hyperlipidemia before the onset of APIP.Forty-nine (77.78%) patients received conservative therapy and 14 (22.22%),surgical operations.A total of 58 (92.06%) patients recovered.The mortality during pregnancy was 7.94% (5 cases) for the pregnant women,and 21.21% (14 cases) for the fetuses.In most of these cases,the major causes for death were MSOF and ARDS.Fourteen cases received termination of pregnancy and 49 continued their pregnancy.There were 5 cases (7.94%) of missed diagnosis,and misdiagnosis.Conclusion The occurrence of APIP is mainly related to gallstone and hyperlipidemia and it is prone to occur during the midterm and late stage of pregnancy.Since the clinical presentation of APIP is complex,misdiagnosis is likely and it threatens the lives of mother and fetus seriously.For the purpose of increasing the curative rate and reducing the mortality of APIP,taking hold of its features,raising the vigilance of discerning APIP,making an early correct diagnosis and proper individualized therapy principles,and the timely termination of pregnancy are of great importance. Key words: Pancreatitis; Pregnancy complication; Diagnosis; Treatment