>Year 2003, Issue 2
Díaz-Pizarro GJI, Mijares-García JM, Cárdenas-Lailson LE
Prevalence of acute pancreatitis during pregnancy and the puerperium
Cir Gen 2003; 25 (2)
PDF: 4. Kb.
Objective: To determine the prevalence and characteristics of acute pancreatitis during pregnancy and puerperium.
Design: Descriptive, open, observational, retrospective, longitudinal study.
Setting: Third level health care hospital.
Methods: Analysis of clinical histories in search of woman patients with acute pancreatitis. Pregnancy or puerperium was confirmed with dates of last menstruation or last delivery and pregnancy tests. Obstetric care and pathological puerperium statistics were reviewed.
Results: Three-hundred twenty-seven hospital releases of patients with acute pancreatitis (355 events) were recorded; of these 13 (13 events) were pregnant (group A) and 15 (16 events, due to recurrence) were in puerperium (group B). Obstetric care was given to 29,238 patients and 249 patients received care for pathological puerperium. Rate of pancreatitis during pregnancy was of 1 in 2,249.08 patients and that of puerperium was 1 in 15.56 patients with pathological puerperium. We also analyzed age of presentation, weeks of gestation or days of puerperium at which the event occurred, etiology and severity of the pancreatitis, duration of hospital stay, administration of nutritional support, evolution of pregnancy, recurrences, type of treatment, maternal and fetal morbidity and mortality in each group.
Conclusion: Pancreatitis is not frequent during pregnancy or puerperium, although it occurs at a high percentage in women with pathological puerperium. The maternal-fetal morbidity and mortality that can be associated requires an early diagnosis, determination of the etiology and severity, as well as its adequate treatment by a multidisciplinary team.
||Acute pancreatitis, pregnancy, puerperium.
Riely C. Pregnancy related hepatic and gastrointestinal disorders. In: Sleisenger, Fordtran. Gastrointestinal and liver disease. 6th ed. WB Saunders Company, USA. 1998: 1253-64.
Banks PA. Acute and chronic pancreatitis. In: Sleisenger, Fordtran. Gastrointestinal and liver disease. 6th ed. WB Saunders Company, USA. 1998: 809-62.
Bradley EL 3rd. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch Surg 1993; 128: 586-90.
Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng K, Spencer FC. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet 1974; 139: 69-81.
Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med 1985; 13: 818-29.
Fallon WF Jr, Newman JS, Fallon GL, Malangoni MA. The surgical management of intra-abdominal inflammatory conditions during pregnancy. Surg Clin North Am 1995; 75: 15-31.
Aufses AH. Gastrointestinal disorders during pregnancy. American College of Gastroenterology Symposium. Sept. 1994.
Parish FM, Richardson JB. Acute pancreatitis during pregnancy: with report of a case. Am J Obstet Gynecol 1956; 72: 906-9.
Corlett RC Jr, Mishell DR Jr. Pancreatitis in pregnancy. Am J Obstet Gynecol 1972; 113: 281-90.
Ramin KD, Ramin SM, Richey SD, Cunningham FG. Acute pancreatitis in pregnancy. Am J Obstet Gynecol 1995; 173: 187-91.
Maringhini A, Lankisch MR, Zinsmeister AR, Melton LJ 3rd, DiMagno EP. Acute pancreatitis in the postpartum period: a population-based case-control study. Mayo Clin Proc 2000; 75: 361-4.
Wilkinson EJ. Acute pancreatitis in pregnancy: a review of 98 cases and a report of 8 new cases. Obstet Gynecol Surv 1973; 28: 281-303.
Valdivieso V, Covarrubias C, Siegel F, Cruz F. Pregnancy and cholelithiasis: pathogenesis and natural course of gallstones diagnosed in early puerperium. Hepatology 1993; 17: 1-4.
Scott LD. Gallstone disease and pancreatitis in pregnancy. Gastroenterol Clin North Am 1992; 21: 803-15.
Dreiling DA, Bordalo O, Rosenberg V, Rudick J. Pregnancy and pancreatitis. Am J Gastroenterol 1975; 64: 23-5.
Rosenberg V, Rudick J, Robbiou M, Dreiling DA. Pancreatic exocrine secretion during and after pregnancy. Ann Surg 1975; 181: 47-50.
Castañón-González JA, Vázquez-de Anda GF, Gallegos-Pérez H, Hernández-López G, Eid-Lidt G, Miranda-Ruíz R. Hígado graso agudo del embarazo complicado con pancreatitis. Gác Méd Méx 1997; 133: 253-8.
Pérez PE, Lagarriga AJ, Sánchez GJI. Pancreatitis y embarazo. Ginecol Obstet Mex 1980; 47: 137-42.
Yáñez MI, Acosta SJA, Hinojosa MM, de la Luz Espinosa MML, Díaz de León PM. Pancreatitis y embarazo. Ginecol Obstet Mex 1978; 44: 441-9.
Steinbrook RA, Brooks DC, Datta S. Laparoscopic cholecystectomy during pregnancy. Review of anesthetic management, surgical considerations. Surg Endosc 1996; 10: 511-5.
Wishner JD, Zolfaghari D, Wohlgemuth SD, Baker JW Jr, Hoffman GC, Hubbard GW et al. Laparoscopic cholecystectomy in pregnancy. A report of 6 cases and review of the literature. Surg Endosc 1996; 10: 314-8.
Martin IG, Dexter SP, McMahon MJ. Laparoscopic cholecystectomy in pregnancy. A safe option during the second trimester? Surg Endosc 1996; 10: 508-10.
Curet MJ, Allen D, Josloff RK, Pitcher DE, Curet LB, Miscall BG et al. Laparoscopy during pregnancy. Arch Surg 1996; 131: 546-50; discussion 550-1.
Swisher SG, Hunt KK, Schmit PJ, Hiyama DT, Bennion RS, Thompson JE. Management of pancreatitis complicating pregnancy. Am Surg 1994; 60: 759-62.
Swisher SG, Schmit PJ, Hunt KK, Hiyama DT, Bennion RS, Swisher EM et al. Biliary disease during pregnancy. Am J Surg 1994; 168: 576-9; discussion 580-1.
Jamidar PA, Beck GJ, Hoffman BJ, Lehman GA, Hawes RH, Agrawal RM et al. Endoscopic retrograde cholangiopancreatography in pregnancy. Am J Gastroenterol 1995; 90: 1263-7.
Legro RS, Laifer SA. First-trimester pancreatitis. Maternal and neonatal outcome. J Reprod Med 1995; 40: 689-95.
Barthel JS, Chowdhury T, Miedema BW. Endoscopic sphincterotomy for the treatment of gallstone pancreatitis during pregnancy. Surg Endosc 1998; 12: 394-9.
Baillie J, Cairns SR, Putman WS, Cotton PB. Endoscopic management of choledocholithiasis during pregnancy. Surg Gynecol Obstet 1990; 171: 1-4.
Liberman MA, Phillips EH, Carroll B, Fallas M, Rosenthal R. Management of choledocholithiasis during pregnancy: a new protocol in the laparoscopic era. J Laparoendosc Surg 1995; 5: 399-403.
>Year 2003, Issue 2