Acute pancreatitis in pregnancy

Chen, Chie-Pein; Wang, Kuo-Gon; Su, Tsung-Hsien; Yang, Yuh‐Cheng

doi:10.3109/00016349509013471

Cited by 30 publications

(22 citation statements)

References 13 publications

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“…20 Although the exact causal and temporal relationship of pancreatitis and preeclampsia has not been established, increasingly, case reports and small studies in the literature have attempted to demonstrate an association. [10][11][12][13][14][15][16][17] Our findings of an association between hypertensive disease and pancreatitis during pregnancy corroborate these publications.…”

Section: Hacker Et Alsupporting

confidence: 94%

Maternal and fetal outcomes of pancreatitis in pregnancy

Hacker

Whalen

Lee

et al. 2015

American Journal of Obstetrics and Gynecology

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Section: Hacker Et Alsupporting

confidence: 94%

Maternal and fetal outcomes of pancreatitis in pregnancy

Hacker

Whalen

Lee

et al. 2015

American Journal of Obstetrics and Gynecology

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“…Some include all cases of pancreatitis (8,9) while others report only acute or biliary pancreatitis (1,7,10–12); some include only cases occurring during pregnancy (9–11) while others also include postpartum cases (1, 7–8). Furthermore, due to the rarity of this condition, the number of cases in these reviews is typically small.…”

Section: Introductionmentioning

confidence: 99%

Pancreatitis in Pregnancy

Eddy

Gideonsen

Song

et al. 2008

Obstetrics &Amp; Gynecology

210

112

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Objective To estimate the incidence, etiology and complications of pancreatitis in pregnancy and identify factors associated with adverse outcomes. Methods Chart review of all patients diagnosed with pancreatitis and pregnancy from 1992–2001 at 15 participating hospitals. Information was collected on presentation, management and outcome, along with the number of deliveries at each hospital. Results During the 10 years of the study, 101 cases of pancreatitis occurred among 305,101 deliveries, yielding an incidence of one in 3,021 (.03%). There were no maternal deaths; perinatal mortality was 3.6%. Eighty-nine women had acute pancreatitis and twelve women had chronic pancreatitis. The majority (66%) of cases of acute pancreatitis were biliary in origin, and they were associated with better outcomes than non-biliary etiologies. Cases of gallstone pancreatitis that received surgical or endoscopic intervention during pregnancy had lower rates of preterm delivery and recurrence than those that were conservatively managed, but this difference was not significant (p=0.2). Alcohol was responsible for 12.3% of acute pancreatitis and 58% of chronic pancreatitis and was associated with increased rates of recurrence and preterm delivery. A calcium level, triglycerides or both was not obtained in half of cases identified as idiopathic. Conclusion Pancreatitis is a rare event in pregnancy, occurring in approximately 3 in 10,000 pregnancies. While it is most often acute and related to gallstones, non-biliary causes should be sought, as they are associated with worse outcomes.

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“…Conventional treatment options as lipid-lowering drugs, including fish oil preparations, have not been investigated for clinical safety and efficacy during pregnancy. Alternative therapies for hypertriglyceridemia include intravenous heparin in combination with insulin, complete avoidance of enteral calorie supplementation and parenteral electrolyte substitution [2,[4][5][6]. For total parenteral nutrition, central venous catheters and continuous hospitalization is required [7,8].…”

Section: Discussionmentioning

confidence: 99%

Immunoadsorption and Plasma Exchange in Pregnancy

Dittrich¹,

Schmaldienst²,

Langer³

et al. 2002

Kidney Blood Press Res

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Background: During pregnancy, familial hyperlipidemia or systemic lupus erythematosus (SLE) can exacerbate having devastating consequences for both mother and fetus. Immunoadsorption is established for removal of pathogenic proteins lipoproteins or autoantibodies, but this procedure has only rarely been used in pregnancy. Methods: We evaluated retrospectively 126 extracorporeal treatments during six pregnancies. Forty low-density lipoprotein immunoadsorptions, 6 sole plasma exchanges and 36 combined procedures (plasma exchange followed by immunoadsorption) were performed for severe hypertriglyceridemia, complicated by acute pancreatitis. Forty-four IgG immunoadsorptions were executed in 2 pregnant women suffering from SLE with a disastrous course during prior pregnancies. Results: In hyperlipidemic pregnant women, mean triglyceride levels prior to treatment were 3,841 ± 2,076 mg/dl (mean ± SD) and total cholesterol was 617 ± 354 mg/dl. Until delivery, a 27% reduction of triglycerides could be achieved. Clinical and serological signs of pancreatitis disappeared after initiation of extracorporeal therapy. Four healthy babies were delivered (birthweights between 2,250 and 3,360 g). In 1 woman suffering from SLE, intrauterine fetal death occurred in the 22nd week of gestation despite a reduction of cardiolipin antibodies by 69%. The second case (a twin pregnancy) was complicated by steroid-resistant antibody-mediated anemia. Due to frequent immunoadsorptions, red blood cell count improved (reduction of antierythrocyte antibodies by 66.6%) and 2 healthy babies (birthweights 2,120 and 2,350 g) were delivered by cesarean section. Conclusion: Long-term antibody-based immunoadsorption has been demonstrated to be safe and well tolerated in pregnant women and enables normal intrauterine/fetal development. Although rarely indicated during pregnancy, this treatment modality might be a promising new technique for removal of autoantibodies and lipoproteins in patients with serious gestational complications without sufficient response to conventional therapy.

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Acute pancreatitis in pregnancy

Cited by 30 publications

References 13 publications

Maternal and fetal outcomes of pancreatitis in pregnancy

Maternal and fetal outcomes of pancreatitis in pregnancy

Pancreatitis in Pregnancy

Immunoadsorption and Plasma Exchange in Pregnancy

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