Maternal and perinatal outcome of acute pancreatitis during pregnancy: a 5 year experience at a tertiary care centre -

Background: Acute pancreatitis in pregnancy (APIP) is rare and occurs in approximately 1 in 1000 to 1 in 4000 births. The most common symptom of acute pancreatitis is epigastric pain radiating to the back which is accompanied by nausea, vomiting and fever. The aim of the study was to evaluate the maternal and perinatal outcome of acute pancreatitis during pregnancy.Methods: Six antenatal mothers identified with acute pancreatitis at St. John’s Medical College Hospital, Bengaluru from June 2011 to March 2016 were followed up in the antenatal, postnatal period and their outcomes were evaluated.Results: There were six cases of acute pancreatitis, with 11,053 deliveries during this 5 year study. Incidence was 1 in 1831. All patients presented with epigastric pain, vomiting and required repeated episodes of admission. There were 14 episodes of acute pancreatitis in these 6 patients. Pancreatitis was severe in 3 patients, with most attacks occurring in third trimester. Etiology was biliary pancreatitis (gallstones) in 2 patients, preeclampsia in 2, idiopathic 1 and hypertriglyceridemia in one patient. Five patients delivered preterm. There were no abortions, fetal loss, maternal and neonatal mortality.Conclusions: The course of acute pancreatitis in pregnancy is usually mild and self-limiting. But, it can be rapidly progressive and fulminant with complications like electrolyte imbalance, ARDS and DIC. Most patients delivered preterm. Conservative management till delivery by multidisciplinary team lead to good maternal and perinatal outcome.