A 23-year, single-center, retrospective analysis of 36 cases of acute pancreatitis in pregnancy

Abstract

Objective: To assess the incidence, causes, clinical characteristics, and outcomes of cases of acute pancreatitis in pregnancy (APIP).

Methods: A retrospective review was conducted of the medical records of pregnant women who were diagnosed with APIP at any point during pregnancy, labor, or the puerperium and attended Beijing Chaoyang Hospital, China, between January 1, 1991, and March 31, 2014.

Results: Among 34 292 pregnant women admitted to the center during the study period, 36 patients were diagnosed with APIP. The condition developed during the second (9 [25%] cases) and third (22 [61%]) trimesters. The underlying cause was hypertriglyceridemia for 14 (39%) patients and biliary diseases for 7 (19%). Severe acute pancreatitis was significantly more common among patients with hypertriglyceridemia (11/14 [79%]) than among those without hypertriglyceridemia (6/22 [27%]; P=0.006). Additionally, complications were recorded for more patients with hypertriglyceridemia (11 [79%]) than those without hypertriglyceridemia (4 [18%]; P<0.001). Delayed diagnosis was more common among patients with severe acute pancreatitis (8/17 [47%]) than among those with mild acute pancreatitis (3/19 [16%]; P=0.039). No maternal deaths and only two perinatal deaths were recorded.

Conclusion: The overall incidence of APIP was low; however, hypertriglyceridemia was associated with poor outcomes. Early diagnosis and prompt treatment should be implemented to improve maternal and fetal prognosis and decrease mortality.

Keywords: Acute pancreatitis in pregnancy; Early diagnosis; Early treatment; Fetal outcome; Hypertriglyceridemia; Pregnancy outcome.