ACUTE-PANCREATITIS IN PREGNANCY

OBJECTIVE: Our purpose was to determine the cause and describe the nat ural history of acute pancreatitis complicating pregnancy and its effe ct on maternal and perinatal outcomes. STUDY DESIGN: Over the last dec ade we admitted 43 pregnant women with acute pancreatitis to our hospi tal. We reviewed presentation, diagnosis, management, and maternal and perinatal outcomes. RESULTS: The incidence of acute pancreatitis was one in 3333 pregnancies. The mean age of these 43 women was 24 years, 31 (72%) were multiparous, and pancreatitis was associated with biliar y disease in 29 (68%). All had a favorable response to supportive ther apy that included bowel rest, intravenous hydration, and antimicrobial therapy. Cholecystectomy was performed for persistent or recurrent bi liary or pancreatic disease ante partum in eight women and post partum in another 12. Of 39 women who were delivered at our hospital, 32 wer e at term and their infants did well. The other six infants were deliv ered preterm; two were stillborn and another died after birth. One wom an underwent a therapeutic abortion. CONCLUSIONS: Most pregnant women with acute pancreatitis have associated biliary tract disease. With pr ompt hospitalization, supportive care, and surgical intervention when indicated, maternal and fetal morbidity and mortality are not prohibit ive. Fetal death and preterm delivery may result from severe disease.