Hypertriglyceridemia Induced Acute Pancreatitis in Pregnancy: A Case Report

Keywords: Acute pancreatitis, Hypertriglyceridemia, Pregnancy

Abstract

Introduction: Acute pancreatitis is a rare event in pregnancy. Hypertriglyceridemia induced acute pancreatitis accounts for the second most common cause in pregnancy. This rare event has a high maternal and fetal mortality of 20% and 50% respectively. Case report: A 21-year-old woman, G2P0+1 at 26 weeks period of gestation presented to OBGYN emergency in a state of shock with history of sudden onset of severe epigastric pain and multiple episodes of vomiting for one day and absent fetal movement for six hours. Immediate fluid resuscitation was done. Her reports showed increased hematocrit, leukocytosis, serum lipase and amylase elevated to > 200U/L. Ultrasonography showed bulky pancreas with intrauterine fetal death. With the diagnosis of acute pancreatitis with fetal demise, she was managed conservatively in intensive care unit by fasting, nasogastric aspiration, intravenous fluids, antibiotics, analgesics and heparin. She was intubated on the third day for increasing tachypnea. Her lipid profile showed elevated triglyceride> 1000 mg/dl and was started on oral hypolipidemic drugs. Pregnancy was terminated vaginally by misoprostol and was discharged on 19th day. Conclusion: Hypertriglyceridemia induced acute pancreatitis in pregnancy has an increased maternal and fetal complication.

Downloads

Download data is not yet available.

Author Biographies

Anjali Subedi, Manipal College of Medical Sciences

Lecturer, Department of Obstetrics and Gynecology.

Sonam Gurung, Manipal College of Medical Sciences

Resident, Department of Obstetrics and Gynecology.

References

James D, Steer P, Weiner C, Gonik B. High Risk Pregnancy: management options. 4th edition. St. Louis: Saunders; 2010.

Ducarme G, Maire F, Chatel P, Luton D, Hammel P. Acute pancreatitis during pregnancy: a review. J Perinatol. 2014;34(2):87–94. PMID: 24355941. DOI: https://doi.org/10.1038/jp.2013.161

Qihui C, Xiping Z, Xianfeng D. Clinical Study on Acute Pancreatitis in Pregnancy in 26 Cases. Gastroenterology Research and Practice. 2012;Aricle ID 271925:1-5. DOI: https://doi.org/10.1155/2012/271925

Pitchumoni CS, Yegneswaran B. Acute pancreatitis in pregnancy. World J Gastroenterol. 2009;15(45):5641-6. PMID: 19960559. DOI: https://doi.org/10.3748/wjg.15.5641

Jeon HR, Kim SY, Cho YJ, Chon SJ. Hypertriglyceridemia-induced acute pancreatitis in pregnancy causing maternal death. Obstet Gynecol Sci. 2016;59(2):148- 51. PMID: 27004207. DOI: https://doi.org/10.5468/ogs.2016.59.2.148

Gan SI, Edward AL, Symonds CJ, Beck PL.Hypertriglyceridemia-induced pancreatitis A case-based review.World J Gastroenterol. 2006;12(44):7197-202. PMID: 17131487. DOI: https://doi.org/10.3748/wjg.v12.i44.7197

Sreelatha S, Nayak V, Nataraj. Acute Pancreatitis in Pregnancy. Indian Journal of Clinical Practice. 2012;23(4):231–2. Available from: http://medind.nic.in/iaa/t12/i9/iaat12i9p231.pdf

Ntzeros K, Fragiadakis I, Stamatakos M. Acute pancreatitis in pregnancy — Up to date. Open Journal of Obstetrics and Gynecology. 2014;4(2):81–9. DOI: http://dx.doi.org/10.4236/ojog.2014.42015

Cruciat G, Nemeti G, Goidescu I, Anitan S, Florian A. Hypertriglyceridemia triggered acute pancreatitis in pregnancy – diagnostic approach , management and follow-up care. Lipids Health Dis. 2020;19(2):1–6. DOI: https://doi.org/10.1186/s12944-019-1180-7

Gupta N, Ahmed S, Shaffer L, Cavens P, Blankstein J, Presentation C. Severe Hypertriglyceridemia Induced Pancreatitis in Pregnancy. Case Reports in Obstetrics and Gynecology. 2014;Article ID 485493:1-5. DOI: https://doi.org/10.1155/2014/485493

Published
2020-05-21
How to Cite
1.
Subedi A, Gurung S. Hypertriglyceridemia Induced Acute Pancreatitis in Pregnancy: A Case Report. J Lumbini Med Coll [Internet]. 21May2020 [cited 25Sep.2020];8(1):92-5. Available from: https://jlmc.edu.np/index.php/JLMC/article/view/321
Section
Case Report