Acute Pancreatitis During Pregnancy

• Published in: Clinical gastroenterology and hepatology Vol. 8; no. 1; pp. 85 - 90
• Main Authors: Tang, Shou–Jiang, Rodriguez–Frias, Edmundo, Singh, Sundeep, Mayo, Marlyn J, Jazrawi, Saad F, Sreenarasimhaiah, Jayaprakash, Lara, Luis F, Rockey, Don C
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2010
• Subjects: Adult; Cohort Studies; Disseminated Intravascular Coagulation - epidemiology; Female; Fetal Mortality; Gastroenterology and Hepatology; Humans; Pancreatitis, Acute Necrotizing - complications; Pancreatitis, Acute Necrotizing - epidemiology; Pregnancy; Pregnancy Complications - epidemiology; Premature Birth; Retrospective Studies; Treatment Outcome; Young Adult; endoscopic retrograde cholangiopancreatography; CT; disseminated vascular coagulation; Parkland Memorial Hospital; ERCP; PMH; computerized tomography; DIC
• ISSN: 1542-3565; 1542-7714
• DOI: 10.1016/j.cgh.2009.08.035

Background & Aims Acute pancreatitis is rare during pregnancy; limited data are available about maternal and fetal outcomes. We investigated the effects of acute pancreatitis during pregnancy on fetal outcome. Methods This retrospective cohort study, performed at a single academic center, included consecutive pregnant women who presented with (n = 96) or developed acute pancreatitis in the hospital (n = 7) in 2000–2006 (mean age, 26 y). Patient histories and clinical data were collected from medical records. Results Of the 96 patients with spontaneous pancreatitis, 4 had complications: 1 patient in the first trimester had acute peripancreatic fluid collection, and 3 patients in the third trimester developed disseminated vascular coagulation (DIC). None of these patients achieved term pregnancy, and 1 of the patients with DIC died. Endoscopic retrograde cholangiopancreatography (ERCP) was performed in 23 patients with acute pancreatitis; post-ERCP pancreatitis was diagnosed in 4 patients (a total of 11 patients developed ERCP-associated pancreatitis). Term pregnancy was achieved in 73 patients (80.2%). Patients who developed pancreatitis in the first trimester had the lowest percentage of term pregnancy (60%) and highest risks of fetal loss (20%) and preterm delivery (16%). Of the patients with pancreatitis in the second and third trimesters, only one had fetal loss. Fetal malformations were not observed. Conclusions The majority of pregnant patients with acute pancreatitis did not have complications; most adverse fetal outcomes (fetal loss and preterm delivery) occurred during the first trimester. Acute pancreatitis, complicated by DIC, occurred most frequently in the third trimester and was associated with poor fetal and maternal outcomes.