November 12, 2014
Wesley, Alexander J
Biomed Rep. 2014 Mar;2(2):193-198. Epub 2013 Nov 29.
Author Address: Department of General Surgery, West China Hospital, West China Medical School, University of Sichuan, Chengdu, Sichuan 610041, P.R. China.
Department of Nursing, West China Hospital, West China Medical School, University of Sichuan, Chengdu, Sichuan 610041, P.R. China.
Department of Surgery, Division of Transplantation, University of Cincinnati Medical Center, Cincinnati, OH 45221-0091, USA.
Reference Type: Journal Article
Record Number: 4652Author: Ducarme, G., Maire, F., Chatel, P., Luton, D. and Hammel, P.
Title: Acute pancreatitis during pregnancy: a review
Journal: J Perinatol
Short Title: Acute pancreatitis during pregnancy: a review
Alternate Journal: Journal of perinatology : official journal of the California Perinatal Association
ISSN: 1476-5543 (Electronic)
Accession Number: 24355941
Cholangiopancreatography, Endoscopic Retrograde
Abstract: This article aims to draw together recent thinking on pregnancy and acute pancreatitis (AP), with a particular emphasis on pregnancy complications, birth outcomes and management of AP during pregnancy contingent on the etiology. AP during pregnancy is a rare but severe disease with a high maternal-fetal mortality, which has recently decreased thanks to earlier diagnosis and some maternal and neonatal intensive care improvement. AP usually occurs during the third trimester or the early postpartum period. The most common causes of AP are gallstones (65 to 100%), alcohol abuse and hypertriglyceridemia. Although the diagnostic criteria for AP are not specific for pregnant patients, Ranson and Balthazar criteria are used to evaluate the severity and treat AP during pregnancy. The fetal risks from AP during pregnancy are threatened preterm labor, prematurity and in utero fetal death. In cases of acute biliary pancreatitis during pregnancy, a consensual strategy could be adopted according to the gestational age, and taking in consideration the high risk of recurrence of AP (70%) with conservative treatment and the specific risks of each treatment. This could include: conservative treatment in first trimester and laparoscopic cholecystectomy in second trimester. During the third trimester, conservative treatment or endoscopic retrograde cholangiopancreatography with biliary endoscopic sphincterotomy, and laparoscopic cholecystectomy in early postpartum period are recommended. A multidisciplinary approach, including gastroenterologists and obstetricians, seems to be the key in making the best choice for the management of AP during pregnancy.