This article provides information for patients on acute pancreatitis during pregnancy.
Table of contents:
Acute pancreatitis
Acute pan creatitis is a condition that occurs very rarely during pregnancy.
It is generally accepted that acute pancreatitis is the result of pancreatic self-digestion by pancreatic enzymes. The most common cause of this condition is gallstones, but also alcohol abuse, chronic medical conditions, certain medications and viral diseases.
In pregnant women, acute pancreatitis is most often associated with gallstones, as there are certain factors that favour the occurrence of gallstones during pregnancy. Acute pancreatitis can occur at any time during pregnancy, but is most common in the second and third trimesters and in the postpartum period. More often, acute pancreatitis occurs in women who have already given birth.
Symptoms of pancreatitis
Pancreatitis most often begins with gastrointestinal distress and epigastric pain that radiates to the left rib arch and left back. The pain is often accompanied by vomiting and nausea. When pressure is applied to the epigastrium, a significant increase in pain can be detected. In cases of fairly advanced pancreatitis, loss of appetite, digestive difficulties, general weakness and alternating constipation with diarrhoea may occur. The stools are smelly and quite profuse.
In most cases, acute pancreatitis is mild and passes within a few days, but in some cases it can be severe with significant mortality. For pregnant women, the prognosis is serious and depends on the form of acute pancreatitis. A distinction is made between a mild form, which is endobronchial, and a severe form, which is necrotising.
The diagnosis of acute pancreatitis during pregnancy is sometimes difficult. This is primarily due to the rare occurrence of this condition in pregnancy and also because of the lack of unambiguous symptoms indicating this disease. Acute pancreatitis during pregnancy is sometimes confused with appendicitis and cholecystitis, among others.
Treatment of pancreatitis
When acute pancreatitis is correctly diagnosed, pharmacological treatment is of primary importance. It mainly consists of fluid supplementation, possible oxygen supply, the introduction of starvation, suctioning of gastric contents, parenteral nutrition, and in severe cases the administration of antibiotics. Surgical treatment is only carried out in selected cases.
In a patient with acute pancreatitis, pregnancy should be maintained, except in cases where there is a risk to the foetus, in which case the pregnancy should be terminated by caesarean section.
