A case report of complete recovery of acute pancreatitis at 32 weeks of pregnancy

Document Type : Case report

Authors

1 Assistant Professor, Department of Obstetrics and Gynecology, Fellowship of perinatology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.

2 Associate Professor, Department of Obstetrics and Gynecology, Fellowship of Infertility, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

10.22038/ijogi.2024.79343.6063

Abstract

Introduction: Acute pancreatitis during pregnancy is uncommon, but due to the symptoms similar to other diseases during pregnancy, it may not be easily diagnosed. Delay in diagnosis is associated with serious maternal and fetal complications and even death. After delivery, with acute pancreatitis, the rate of maternal mortality, postpartum hemorrhage, and complications related to hypertension are higher. This disease can lead to premature birth and, in severe cases, fetal death due to placental dysfunction. In this study, we report a case of acute pancreatitis in pregnancy, which was completely cured with proper management.
Case presentation: A 37-year-old woman with 32 weeks of gestation and complain of epigastric pain without nausea and vomiting, and normal blood pressure, with suspicion of preeclampsia with severe features was sent from the second-level women's center to the third-level center (Shahid Beheshti hospital of Kashan). In both centers, creatinine, liver enzymes, hemoglobin and platelets were normal and only proteinuria was present. The pain worsened with eating and acute pancreatitis was diagnosed with surgical consultation and serum amylase and lipase measurements. Medical treatment was done with management of a team including gastroenterologist, surgeon, gynecologist, nutritionist and infectious disease, and she was discharged after eight days with the resolution of clinical symptoms and the normalization of tests and the continuation of oral medications. The estimated fetal weight and the amniotic fluid in ultrasound were normal. Fetal health tests were performed daily.
Conclusion: Although acute pancreatitis during pregnancy is uncommon, but due to the similarity of the symptoms with some more common complications of pregnancy, such as HELLP syndrome and preeclampsia, there is a possibility of delay in diagnosis. If not diagnosed and treated on time, it can be associated with severe morbidity and even maternal and fetal mortality.

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References

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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 27, Issue 6
August 2024
Pages 78-83

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