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Surgical Medicine Open Access Journal

Pregnancy Associated Acute Pancreatitis: A Practical Approach

Submission:November 22, 2022;Published: August 07, 2023

DOI: 10.31031/SMOAJ.2023.05.000612

ISSN : 2578-0379
Volume5 Issue3

Pregnancy associated with acute pancreatitis is a potentially life-threatening but rare event occurring in approximately three in 10000 pregnancies. Its prompt diagnosis warrants a high degree of suspicion in women who present with severe upper abdominal pain which may or may not radiate to the back. These patients usually have accompanying anorexia, nausea and vomiting. Serum amylase, lipase, CRP and abdominal ultrasound should be included in the initial workup for these symptoms occurring during pregnancy. It occurs usually during the third trimester or the early postpartum period. Once the diagnosis of acute pancreatitis is established, the mainstay of treatment is symptomatic including aggressive fluid resuscitation if not otherwise contraindicated and pain relief; antibiotics should not be initiated at this stage. Next it would be imperative to ascertain the severity of the disease using established criteria such as the modified Glasgow or Atlanta’s criteria within the first 48 hours of admission.

The patient is kept under close observation with fetal monitoring and swift action taken on signs of clinical deterioration e.g., rising respiratory rate, worsening pain, increasing tachycardia, hypoxia or low urinary output. Most pregnant women with moderate acute pancreatitis and all with severe disease will require intensive care support. Gallstones, hypertriglyceridemia and alcohol use are the main causes which will necessitate treatment consideration on an individual basis. Mild disease usually resolves without any major intervention or sequel whereas timing of intervention in others is crucial for good outcome. To minimize maternal and fetal mortality and morbidity diligent decision-making related to the termination of pregnancy and the management of acute pancreatitis with its underlying pathology will require a multidisciplinary team approach. This should include obstetrician, surgeon, interventional gastroenterologist, radiologist and ICU staff.

Keywords:Pregnancy; Acute pancreatitis; Management; Outcome; Fetal loss

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