Acute pancreatitis in pregnancy: a comparison of associated conditions, treatments and complications
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Audrey Gilbert
Abstract
Objective: Acute pancreatitis is a rare condition in pregnancy. The aim of this study is to compare associated conditions, treatments and complications of pancreatitis in pregnant and age-matched non-pregnant controls.
Methods: We carried out a population-based retrospective cohort study using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS) from 2003 to 2010. A cohort of pregnant women with acute pancreatitis was created and compared to a created age-matched cohort of non-pregnant women with acute pancreatitis at a 1:4 ratio. Comparisons of associated conditions, treatment types, and complications were carried out using unconditional logistic regression.
Results: We identified 7725 cases of acute pancreatitis in pregnancy. As compared to non-pregnant controls, pancreatitis in pregnancy was more likely to be associated with cholelithiasis and less likely with hyperlipidemia and alcohol abuse. Pancreatitis in pregnancy was more likely to be treated with parenteral nutrition and less likely to undergo endoscopic sphincterotomy. As compared to non-pregnant controls, pregnant women with pancreatitis were less likely to have pancreatic pseudocysts/hemorrhage/necrosis, generalized peritonitis, adult respiratory distress syndrome, disseminated intravascular coagulation, and death.
Conclusion: Pancreatitis in pregnancy is predominantly caused by cholelithiasis, and unlike in the non-pregnant state, usually has a milder course.
References
[1] Al-Omran M, Albalawi ZH, Tashkandi MF, Al-Ansary LA. Enteral versus parenteral nutrition for acute pancreatitis. Cochrane Database Syst Rev. 2010;CD002837.10.1002/14651858.CD002837.pub2Suche in Google Scholar
[2] Corlett RC, Jr, Mishell DR, Jr. Pancreatitis in pregnancy. Am J Obstet Gynecol. 1972;113:281–90.10.1016/0002-9378(72)90672-2Suche in Google Scholar
[3] Cruz-Santamaria DM, Taxonera C, Giner M. Update on pathogenesis and clinical management of acute pancreatitis. World J Gastrointest Pathophysiol. 2012;3:60–70.10.4291/wjgp.v3.i3.60Suche in Google Scholar
[4] Date RS, Kaushal M, Ramesh A. A review of the management of gallstone disease and its complications in pregnancy. Am J Surg. 2008;196:599–608.10.1016/j.amjsurg.2008.01.015Suche in Google Scholar
[5] Eddy JJ, Gideonsen MD, Song JY, Grobman WA, O’Halloran P. Pancreatitis in pregnancy. Obstet Gynecol. 2008;112: 1075–81.10.1097/AOG.0b013e318185a032Suche in Google Scholar
[6] Everson GT. Gastrointestinal motility in pregnancy. Gastroenterol Clin North Am. 1992;21:751–76.10.1016/S0889-8553(21)00599-9Suche in Google Scholar
[7] Fölsch UR, Nitsche R, Lüdtke R, Hilgers RA, Creutzfeldt W. Early ERCP and papillotomy compared with conservative treatment for acute biliary pancreatitis. N Engl J Med. 1997;336:237–42.10.1056/NEJM199701233360401Suche in Google Scholar PubMed
[8] Hernandez A, Petrov M, Brooks D, Banks P, Ashley S, Tavakkolizadeh A. Acute pancreatitis and pregnancy: a 10-year single center experience. J Gastrointest Surg. 2007;11:1623–7.10.1007/s11605-007-0329-2Suche in Google Scholar PubMed
[9] Lankisch PG, Breuer N, Bruns A, Weber-Dany B, Lowenfels AB, Maisonneuve P. Natural history of acute pancreatitis: a long-term population-based study. Am J Gastroenterol. 2009;104:2797–805.10.1038/ajg.2009.405Suche in Google Scholar PubMed
[10] Li HP, Huang YJ, Chen X. Acute pancreatitis in pregnancy: a 6-year single center clinical experience. Chin Med J. 2011;124:2771–5.Suche in Google Scholar
[11] Lu EJ, Curet MJ, El-Sayed YY, Kirkwood KS. Medical versus surgical management of biliary tract disease in pregnancy. Am J Surg. 2004;188:755–9.10.1016/j.amjsurg.2004.09.002Suche in Google Scholar PubMed
[12] Menees S, Elta G. Endoscopic retrograde cholangiopancreatography during pregnancy. Gastrointest Endosc Clin N Am. 2006;16:41–57.10.1016/j.giec.2006.01.004Suche in Google Scholar
[13] Pitchumoni CS, Yegneswaran B. Acute pancreatitis in pregnancy. World J Gastroenterol. 2009;15:5641–6.10.3748/wjg.15.5641Suche in Google Scholar
[14] Ramin KD, Ramin SM, Richey SD, Cunningham FG. Acute pancreatitis in pregnancy. Am J Obstet Gynecol. 1995;173:187–91.10.1016/0002-9378(95)90188-4Suche in Google Scholar
[15] Swisher SG, Hunt KK, Schmit PJ, Hiyama DT, Bennion RS, Thompson JE. Management of pancreatitis complicating pregnancy. Am Surg. 1994;60:759–62.Suche in Google Scholar
[16] Tang SJ, Mayo MJ, Rodriguez-Frias E, Armstrong L, Tang L, Sreenarasimhaiah J, et al. Safety and utility of ERCP during pregnancy. Gastrointest Endosc. 2009;69:453–61.10.1016/j.gie.2008.05.024Suche in Google Scholar PubMed
[17] Tang SJ, Rodriguez-Frias E, Singh S, Mayo MJ, Jazrawi SF, Sreenarasimhaiah J, et al. Acute pancreatitis during pregnancy. Clin Gastroenterol Hepatol. 2010;8:85–90.10.1016/j.cgh.2009.08.035Suche in Google Scholar PubMed
[18] Wilkinson EJ. Acute pancreatitis in pregnancy: a review of 98 cases and a report of 8 new cases. Obstet Gynecol Surv. 1973;28:281–303.10.1097/00006254-197305000-00001Suche in Google Scholar
[19] Wu BU, Banks PA. Clinical management of patients with acute pancreatitis. Gastroenterology. 2013;144:1272–81.10.1053/j.gastro.2013.01.075Suche in Google Scholar PubMed
[20] Yadav D, Lowenfels AB. The epidemiology of pancreatitis and pancreatic cancer. Gastroenterology. 2013;144: 1252–61.10.1053/j.gastro.2013.01.068Suche in Google Scholar PubMed PubMed Central
The authors stated that there are no conflicts of interest regarding the publication of this article.
©2014 by De Gruyter
Artikel in diesem Heft
- Frontmatter
- Editorial
- The CROWN Initiative: journal editors invite researchers to develop core outcomes in women’s health
- Academy’s Corner
- Invasive or non-invasive prenatal genetic diagnosis?
- Original articles - Obstetrics
- Effect of depth on shear-wave elastography estimated in the internal and external cervical os during pregnancy
- Analysis of measurement process of placental volume in early pregnancy: an interobserver reliability study
- Acute pancreatitis in pregnancy: a comparison of associated conditions, treatments and complications
- Cesarean section and placental disorders in subsequent pregnancies – a meta-analysis
- Effect of magnesium sulfate and nifedipine on the risk of developing pulmonary edema in preterm births
- Prediction of preeclampsia by placental protein 13 and background risk factors and its prevention by aspirin
- Maternal and neonatal outcome of labour induction at term comparing two regimens of misoprostol
- Comparison of placental alpha microglobulin-1 in vaginal fluid with intra-amniotic injection of indigo carmine for the diagnosis of rupture of membranes
- Clinical differences between early- and late-onset severe preeclampsia and analysis of predictors for perinatal outcome
- Maternal serum placental growth factor and fetal SGA in pregnancy complicated by type 1 diabetes mellitus
- Original article – Fetus
- Imaging of fetal thymus in pregnant women with rheumatic diseases
- Original articles – Newborn
- Milk demystified by chemistry
- Absence of antibodies against Bordetella pertussis in pregnant women and newborns in the state of Nuevo Leon
- Mortality among sons of female dental personnel – a national cohort study
- IAPM Statements 2005–2012
- DECLARATIONS of the “International Academy of Perinatal Medicine” (IAPM)
- Congress Calendar
- Congress Calendar
Artikel in diesem Heft
- Frontmatter
- Editorial
- The CROWN Initiative: journal editors invite researchers to develop core outcomes in women’s health
- Academy’s Corner
- Invasive or non-invasive prenatal genetic diagnosis?
- Original articles - Obstetrics
- Effect of depth on shear-wave elastography estimated in the internal and external cervical os during pregnancy
- Analysis of measurement process of placental volume in early pregnancy: an interobserver reliability study
- Acute pancreatitis in pregnancy: a comparison of associated conditions, treatments and complications
- Cesarean section and placental disorders in subsequent pregnancies – a meta-analysis
- Effect of magnesium sulfate and nifedipine on the risk of developing pulmonary edema in preterm births
- Prediction of preeclampsia by placental protein 13 and background risk factors and its prevention by aspirin
- Maternal and neonatal outcome of labour induction at term comparing two regimens of misoprostol
- Comparison of placental alpha microglobulin-1 in vaginal fluid with intra-amniotic injection of indigo carmine for the diagnosis of rupture of membranes
- Clinical differences between early- and late-onset severe preeclampsia and analysis of predictors for perinatal outcome
- Maternal serum placental growth factor and fetal SGA in pregnancy complicated by type 1 diabetes mellitus
- Original article – Fetus
- Imaging of fetal thymus in pregnant women with rheumatic diseases
- Original articles – Newborn
- Milk demystified by chemistry
- Absence of antibodies against Bordetella pertussis in pregnant women and newborns in the state of Nuevo Leon
- Mortality among sons of female dental personnel – a national cohort study
- IAPM Statements 2005–2012
- DECLARATIONS of the “International Academy of Perinatal Medicine” (IAPM)
- Congress Calendar
- Congress Calendar
