What may cause fetus loss from acute pancreatitis in pregnancy

Tang, Min; Xu, Jianming; Song, Shasha; Qiao, Mingqi; Zhang, Li-Jiu

doi:10.1097/md.0000000000009755

Cited by 35 publications

(48 citation statements)

References 31 publications

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“…Alcoholism, drug abuse, history of receiving endoscopic retrograde cholangiopancreatography and abdominal surgery were categorized as 'other causes' [19]. Fetal loss included spontaneous or artificially abortion, intrauterine fetal death and induced labor [2].…”

Section: Diagnosis and Definitionsmentioning

confidence: 99%

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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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Section: Diagnosis and Definitionsmentioning

confidence: 99%

“…It accounts for approximately 1/1000 to 1/12,000 of pregnancies [1]. Data from recent Chinese studies indicated higher incidence up to 1.37% and 2.27%, respectively [2,3]. APIP is more dangerous to the fetus than to the mother.…”

Section: Introductionmentioning

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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“…Studies have shown that risk of fetal loss is more in cases of acute pancreatitis in pregnancy due to hypertriglyceridemia than other causes of pancreatitis [6]. So these cases need special attention and monitoring for mother and fetus and timely intervention to void maternal and fetal complications.…”

Section: Managing Principlesmentioning

confidence: 99%

“…This may lead to preeclampsia or pancreatitis. Though rare, hypertriglyceridemia induced pancreatitis may lead to fatal maternal and fetal complications, even maternal death [4][5][6]. Acute complications of electrolyte imbalance, acute respiratory distress syndrome, disseminated intravascular coagulation and preterm labour may worsen the clinical situation.…”

Section: Introductionmentioning

confidence: 99%

Hypertriglyceridemia induced acute pancreatitis in pregnancy: Learning experiences and challenges of a Case report

Athar¹,

Ramawat²,

Aziz³

et al. 2019

Clin J Obstet Gynecol

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Hyperglyceridemia induced pancreatitis in pregnancy accounts for 4% of all cases of acute pancreatitis. Though rare, hypertriglyceridemia induced pancreatitis may lead to fatal maternal and fetal complications, even maternal death. Its management during pregnancy remains a challenge for many physicians. Management options are limited in pregnancy. In the refractory cases, management options and timing of delivery is debatable. Here we report a case of hyperglyceridemia induced pancreatitis and the challenges faced in the management.

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“…If AP is not correctly diagnosed and treated, it can lead to pancreatic necrosis, abscess, and multiple organ dysfunction and subsequently maternal and fetal morbidity and mortality. [7][8][9] Despite the issues, there are no guidelines currently available for AP diagnosis and management in pregnant women. In addition, a gallstone disease (acute cholecystitis, choledocholithiasis, cholangitis, or gallstone pancreatitis) is the most common cause of maternal hospitalization in the first year after delivery.…”

Section: Introductionmentioning

confidence: 99%

Acute biliary pancreatitis during pregnancy and post delivery period

Hot

Eğin

Gökçek

et al. 2019

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Acute pancreatitis has an incidence of approximately 1 in 1000 to 5000 pregnancies, and is most often seen in the third trimester or the postpartum period. The most common cause of pregnancy-related acute pancreatitis is cholelithiasis, which accounts for more than 65% of cases. The aim of this study was to present a detailed analysis of 4 years of experience with cases of acute biliary pancreatitis related to pregnancy from a single center. METHODS:The medical records of 55 consecutive patients who were hospitalized in the emergency surgery clinic for acute biliary pancreatitis related to pregnancy between January 1, 2014 and January 1, 2018 were examined in this single-center, retrospective study. RESULTS:Fifty-five patients with acute biliary pancreatitis related to pregnancy were included in the study. Of the 55 women, 13 (24%) were in the pregnant group, 28 (51%) in the postpartum (6 weeks) group, and 14 (25%) were in the 1-year (6 weeks-1 year) group. There was no statistically significant difference between the 3 groups. The most appropriate treatment for each patient was targeted. Six (10%) patients had recurrent acute pancreatitis. There was no maternal or fetal mortality or morbidity. CONCLUSION:Acute biliary pancreatitis related to pregnancy is not limited to pregnant women, and the incidence of these cases was greater than expected. Acute biliary pancreatitis related to pregnancy can be successfully managed with conservative treatment because it usually has a mild to moderate clinical course. However, the surgeon should keep an early cholecystectomy in mind for patients other than those in the first trimester.

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What may cause fetus loss from acute pancreatitis in pregnancy

Abstract: Supplemental Digital Content is available in the text

Cited by 35 publications

References 31 publications

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

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

Hypertriglyceridemia induced acute pancreatitis in pregnancy: Learning experiences and challenges of a Case report

Acute biliary pancreatitis during pregnancy and post delivery period

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