Maternal and fetal outcomes of pancreatitis in pregnancy

Hacker, Francis M.; Whalen, Phoebe; Lee, Vanessa R.; Caughey, Aaron B.

doi:10.1016/j.ajog.2015.07.031

Cited by 32 publications

(17 citation statements)

References 19 publications

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“…Risk factors for the development of acute pancreatitis during pregnancy include gallstones, hyperlipidemia, alcohol consumption, and genetic variants [5, 10]. Our patient had another rare cause of pancreatitis, due to hyperparathyroid-induced hypercalcemia.…”

Section: Discussionmentioning

confidence: 91%

“…Recent studies show that pancreatitis in pregnancy carries maternal and fetal mortality rates of <1% and <5%, respectively [5]. Aside from mortality, there are several other documented maternal and fetal/neonatal complications associated with pancreatitis in pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…Aside from mortality, there are several other documented maternal and fetal/neonatal complications associated with pancreatitis in pregnancy. These include preeclampsia (odds ratio 4.21), preeclampsia with severe features (OR 7.85), preterm delivery at less than 32 weeks (OR 3.31) and 37 weeks (OR 4.10), neonatal respiratory distress syndrome (OR 4.27), and intrauterine fetal demise (OR 4.35) [5]. …”

Section: Discussionmentioning

confidence: 99%

“…The most common cause of pancreatitis in pregnancy is biliary obstruction from gallstones. Acute pancreatitis during pregnancy has also been associated with preeclampsia [5] as well as hypercalcemia [6]. …”

Section: Introductionmentioning

confidence: 99%

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Hyperparathyroidism in Pregnancy Leading to Pancreatitis and Preeclampsia with Severe Features

Dale

Holbrook

Sobel

et al. 2017

Case Reports in Obstetrics and Gynecology

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Background. Hyperparathyroidism is underdiagnosed in pregnancy, yet early diagnosis is necessary for the potentially severe sequelae of hypercalcemia for both the woman and fetus. Case. A 31-year-old, gravida 3, para 0-0-2-0 at 32 weeks and 3 days of gestation, presented with preeclampsia with severe features concomitant with acute pancreatitis and known diabetes mellitus type 2. She was stabilized and delivered. In the postpartum period, her total calcium level remained elevated. Ionized calcium levels and parathyroid hormone levels were also elevated, and she was diagnosed with hyperparathyroidism. Conclusion. Hyperparathyroidism and hypercalcemia are risk factors for pancreatitis. Women who develop pancreatitis during pregnancy are at increased risk of developing preeclampsia. If elevated serum calcium is noted, it should be confirmed with ionized calcium level and parathyroid hormones as ionized calcium levels are unaffected by pregnancy.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hyperparathyroidism in Pregnancy Leading to Pancreatitis and Preeclampsia with Severe Features

Dale

Holbrook

Sobel

et al. 2017

Case Reports in Obstetrics and Gynecology

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“…Pregnancy-associated complications, such as preeclampsia and HELLP syndrome, were also related to APIP [11,12]. A retrospective cohort study from Hacker et al showed that APIP was positively associated with preeclampsia, severe preeclampsia, preterm delivery, and intrauterine fetal death [26]. In the current study, ARDS was the most common complication, and MOF was associated with fetal loss, indicating that the early onset of MOF may indicate a more severe condition with large inflammatory burden, resulting in placental injury.…”

Section: Discussionmentioning

confidence: 99%

Predicting fetal loss in severe acute pancreatitis during pregnancy: a 5-year single-tertiary-center retrospective analysis

Yang

Guo²,

2020

Postgraduate Medicine

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Objective: To determine the factors that predict fetal loss in patients with severe acute pancreatitis. Methods: A total of 96,132 cases including 215 patients with acute pancreatitis were evaluated, and 83 cases with severe acute pancreatitis were included in the study. Clinical data and maternal complications were analyzed. Results: The incidence of acute pancreatitis during pregnancy was 2.24%, of which 38.6%had severe acute pancreatitis. The maternal mortality and fetal mortality were 3.6% and 32.5%, respectively. Hypertriglyceridemia (HTG) was the most common cause of severe acute pancreatitis during pregnancy and, along with delayed diagnosis, was related to fetal loss. The incidence of maternal complications including multiple organ failure (MOF), gestation diabetes mellitus, and preeclampsia was higher in pregnancies with fetal loss compared with those without fetal loss. In multivariable analysis, the independent predictors associated with fetal loss were gestational age (odds ratio [OR],0.183; 95% confidence interval [CI],0.049-0.677; P = 0.0112), HTG (OR,3.477; 95% CI, 2.152-6.674; P = 0.028), time from onset to diagnosis (OR,2.311; 95% CI,1.958-2.967;P = 0.032), MOF (OR,6.579; 95% CI,2.225-9.873; P = 0.039), gestational diabetes mellitus (OR,5.854; 95% CI,3.043-8.661; P = 0.024), and preeclampsia (OR,6.351; 95% CI,3.667-8.965; P = 0.013). A prediction model incorporating these factors demonstrated an area under the receiver operating characteristic curve of 0.909. Conclusion: Severe acute pancreatitis during pregnancy leads to a high rate of fetal mortality. Gestational trimester, delayed diagnosis, HTG, MOF, gestational diabetes mellitus, and preeclampsia are predictors of fetal loss. Therefore, close monitoring is essential for pregnancies complicated with HTG, diabetes mellitus, and hypertension.

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Acute Pancreatitis

Leung

Phelan

2018

Critical Care Obstetrics

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Maternal and fetal outcomes of pancreatitis in pregnancy

Cited by 32 publications

References 19 publications

Hyperparathyroidism in Pregnancy Leading to Pancreatitis and Preeclampsia with Severe Features

Hyperparathyroidism in Pregnancy Leading to Pancreatitis and Preeclampsia with Severe Features

Predicting fetal loss in severe acute pancreatitis during pregnancy: a 5-year single-tertiary-center retrospective analysis

Acute Pancreatitis

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