Risk factors and clinical diagnosis and treatment of acute pancreatitis during pregnancy

ZHANG Li

Abstract：Objective To investigate the risk factors and clinical diagnosis and treatment of acute pancreatitis (AP)during pregnancy. Methods The clinical data of 40 patients diagnosed with AP (AP group) and 50 healthy women (control group)were analyzed retrospectively. The risk factors of AP during pregnancy were analyzed by multivariate Logistic regression analysis. The detection results of blood calcium, fasting plasma glucose (FPG), lipids [total cholesterol (TC), t r iglycer ide (TG)], f ibr inogen (FIB), C-reactive protei n (CR P), ser u m amylase (A MS), white blood cells cou nt ( W BC)and other biochemical i ndexes were compared between the two groups. The treatment outcomes of 40 cases of puer perae with AP were recorded. Results The percentage of complications with biliary tract disease, hyperlipemia, hypercalcemia and hyperglycemia in AP group (47.5%, 40.0%, 42.5%, 37.5%)was significantly higher than that in the control group (P<0.05). Multivariate Logistic regression analysis showed that complications with biliary tract disease, hyperlipemia, hypercalcemia and hyperglycemia were independent risk factors influencing AP during pregnancy (P<0.05). The levels of blood calcium, FPG, TC, TG, FIB, CRP, AMS, WBC and other biochemical indexes in AP group were significantly higher than those in the control group (P<0.05). All the 40 cases of puerperae with AP who had received clinical treatment and their infants survived. 27 of these cases were still in the pregnant state till full-term delivery. 4 cases underwent abdominal drainage and conservative treatment after operation and were cured. 6 cases received cesarean delivery in 36h during conservative treatment. 3 cases underwent aspiration for retroperitoneal pancreatic necrosis after cesarean section. Conclusion Pregnancy complicated with biliary tract disease, hyperlipemia, hypercalcemia and hyperglycemia may increase the risk of AP, which deserves attention; Most puerperae with AP during pregnancy have abnormal blood lipid, blood glucose and blood calcium. Early diagnosis and treatment are the key to achieving ideal outcomes.