Acute pancreatitis and pregnancy: Clinical profile, management and maternal-fetal outcomes

Acute pancreatitis during pregnancy, a rare occurrence primarily noted in the third trimester, has been predominantly linked to gallstone lithiasis. This study delves into the multifaceted landscape of this unique clinical entity, aiming to elucidate its manifestation, clinical presentation, therapeutic strategies, and impact on maternal and fetal well-being. A retrospective investigation encompassing cases from January 2009 to October 2021 scrutinized the clinical trajectories of 31 pregnant or postpartum patients with acute pancreatitis. A comprehensive assessment of their profiles, encompassing demographic data, temporal occurrence, symptomatic manifestations, biochemical markers, and imaging findings, formed the basis of this inquiry. The study revealed a mean patient age of 29 years, with 62% being multiparous. The temporal distribution showcased pancreatitis events occurring in various trimesters, with vomiting and epigastralgia as the predominant symptoms. Serum lipase levels, indicative of pancreatic enzyme perturbation, were notably elevated. A concomitant rise in C-reactive protein levels was observed in a significant proportion of cases. Hepatic cytolysis and renal insufficiency were concomitant factors. Diagnosis was facilitated by a combination of clinical symptoms and imaging findings, thus underlining the importance of clinical vigilance. Gallstone etiology emerged as the foremost causative factor, reinforcing the relevance of gallstone lithiasis in this context. Therapeutic measures centered on symptomatic relief, encompassing fluid resuscitation, pain management, and obstetric monitoring. Maternal and fetal outcomes were characterized by an overall positive trajectory, with a maternal mortality rate of 5.8%. Vaginal deliveries constituted the predominant mode of childbirth, with cesarean sections employed in a minority of cases. This study illuminates the complex interplay between acute pancreatitis and pregnancy, shedding light on diagnostic challenges, therapeutic considerations, and the dynamic maternal-fetal interface. The findings underscore the significance of timely diagnosis and management in optimizing outcomes for both maternal and fetal entities. The pursuit of comprehensive insights into this niche domain remains integral to enhancing our understanding and refining clinical practices for this distinctive clinical scenario.