Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 16 , ISSUE 3 ( May-June, 2024 ) > List of Articles

Original Article

Acute Pancreatitis in Pregnancy: A 2-year Experience at a Tertiary Care Center

Sharanya Hemant, Preet Agarwal, KS Rajeswari

Keywords : Diagnosis, Pancreatitis in pregnancy, Treatment

Citation Information : Hemant S, Agarwal P, Rajeswari K. Acute Pancreatitis in Pregnancy: A 2-year Experience at a Tertiary Care Center. J South Asian Feder Obs Gynae 2024; 16 (3):209-213.

DOI: 10.5005/jp-journals-10006-2301

License: CC BY-NC 4.0

Published Online: 29-04-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Aim: To present a 2-year experience of acute pancreatitis in pregnancy in our institution. Background: Acute pancreatitis during pregnancy is a rare event with incidence, ranging from 1:1,000 to 1:10,000. Biliary tract diseases are the most common cause of acute pancreatitis in pregnancy, with gallstone disease being responsible for more than 70% of cases. Gallstone formation during pregnancy is attributed to the lithogenic effect of pregnancy through estrogen and progesterone. Results: Seven pregnant women with clinical and biochemical diagnosis of acute pancreatitis were studied. The mean gestational age of presentation was 28 weeks, The most common presenting complaint was the upper abdominal pain with vomiting (72%). The maximum amylase level was observed to be 2696 IU/L and the maximum lipase level was 4788 IU/L showing the condition hypertriglyceridemia with the maximum level 757 mg/dL) (28%). One patient had hypocalcemia (5.7 mg/dL) (14%). Six of the seven patients had leukocytosis maximum 22,400/cmm. The corticosteroid-binding globulin (CBG) levels of all patients were normal. The liver function tests (LFTs) of all patients were normal. Three patients had USG features of gallbladder sludge, one patient had gallstones. Three patients required ICU admissions. One patient (14%) had late phase symptoms at 29 weeks gestation requiring UGI Scopy TPN, IV octreotide. Two patients (28%) had moderately severe acute pancreatitis (according to revised Atlanta classification). Clinical significance: It mimics the symptoms of acute fatty liver of pregnancy (AFLP), preeclampsia/hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, and GERD. Hence a thorough understanding of the presentation and differences in management of each condition is required to reduce significant maternal morbidity. Conclusion: Acute pancreatitis in pregnancy is associated with significant maternal morbidity. Early diagnosis, classifying the severity of disease and treatment with multidisciplinary approach was the gold standard treatment.


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