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

Lingyu Luo,Liang Xia,Yin Zhu,Wenhua He,Pi Liu,Hao Zen,Hongrong Xu,Nonghua Lv

doi:10.1007/s00404-017-4558-7

Abstract

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.

Highlights

Acute pancreatitis in pregnancy (APIP) is a rare condition with an approximate incidence of 1 over 1000–12,000 pregnant women [1,2,3,4]
We retrospectively reviewed 121 cases of APIP from 2005 to 2015 in our center to describe the types, clinical characteristics, mortality, and the safety and necessity of gestation termination of acute pancreatitis in pregnancy (APIP) i
Among 121 patients, Gestation was terminated by different approaches, mainly based on fetal and maternal conditions. This case series study described 121 cases of acute pancreatitis in pregnancy in Chinese and showed that the severity of the APIP was correlated with risk for neonate asphyxia, as well as maternal and fetal death

Summary

Introduction

Acute pancreatitis in pregnancy (APIP) is a rare condition with an approximate incidence of 1 over 1000–12,000 pregnant women [1,2,3,4]. It was previously demonstrated that the mortality rate was approximately 37% for the mother and 60% for the fetus, whereas more recently the numbers have decreased significantly due to the improvements in the diagnosis technique, intensive and neonatal care [2, 7,8,9]. We retrospectively reviewed 121 cases of APIP from 2005 to 2015 in our center to describe the types, clinical characteristics, mortality, and the safety and necessity of gestation termination of acute pancreatitis in pregnancy (APIP) i.

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