Abstract
BackgroundIt is known that intra-abdominal hypertension has high morbidity in acute pancreatitis and has detrimental effects on patients. For third trimester pregnancy complicated by acute pancreatitis, the intra-abdominal pressure may have its own characteristic. This article will discuss this clinical scenario.MethodsThis observational study in a cohort group was performed in the surgical intensive care unit of a tertiary hospital. Medical records were reviewed from each acute pancreatitis exactly in third trimester pregnancy. The main statistical methods were Mann–Whitney U test and bivariate Pearson correlation analysis.ResultsDuring the study interval, there were totally 17 pregnancies complicated by acute pancreatitis in the third trimester. All cases with moderate or severe acute pancreatitis had intra-abdominal hypertension of mean value of 16.7 mm Hg (range, 12.9–22.0 mm Hg). The intra-abdominal pressure had significant correlation with APACHE II score (r = 0.7456, p = 0.0006), while a negative correlation was showed with the umbilical artery pH value and with 1-min Apgar score (r = −0.8232, p = 0.0005; r = −0.7465, p = 0.0034; respectively). The intra-abdominal pressure of those with live infants was lower than that of those with dead ones (13.78 ± 2.554 vs. 19.84 ± 1.695, p = 0.0019).ConclusionsThe incidence of intra-abdominal hypertension seems higher in moderate or severe acute pancreatitis in third trimester pregnancy than the non-pregnant cases but there’s no significance in this study. Acute elevated intra-abdominal pressure accounts for great association with mother’s serious scenario and fetal mortality.
Highlights
It is known that intra-abdominal hypertension has high morbidity in acute pancreatitis and has detrimental effects on patients
We reviewed medical records of acute pancreatitis (AP) in third trimester pregnancy in order to investigate the incidence of Intra-abdominal hypertension (IAH) in these populations and to search for a possible correlation between intra-abdominal pressure (IAP) and maternal-fetal outcomes
During the study interval, a total of 53 pregnant women with AP were admitted to our hospital, making up 4.35 % of all cases of AP
Summary
It is known that intra-abdominal hypertension has high morbidity in acute pancreatitis and has detrimental effects on patients. For third trimester pregnancy complicated by acute pancreatitis, the intra-abdominal pressure may have its own characteristic. Elevated intra-abdominal pressure (IAP) is commonly present in critically ill patients. Intra-abdominal hypertension (IAH) has detrimental effects on haemodynamics, respiratory and renal function and may eventually lead to multi-organ failure [1]. It is reported that the mean intra-abdominal pressure at the time of admission is an independent predictor of mortality. The mortality in those patients with IAH on admission is 29.8 % versus 18.6 % in those without IAH [2]. The incidence of IAH is approximately 60-80 % in severe acute pancreatitis (SAP) [3]
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