Acute pancreatitis in the third trimester of pregnancy: a rare case report and management challenges

Abstract

Acute pancreatitis during pregnancy is a rare but potentially life-threatening condition for both mother and fetus, with an estimated incidence ranging from 1 in 1,000 to 1 in 10,000 pregnancies. The third trimester is the most commonly affected period, often due to hormonal and anatomical changes that predispose to gallstone formation and biliary stasis. Clinical presentation is frequently nonspecific and may mimic other obstetric or gastrointestinal conditions, making timely diagnosis challenging. Common etiologies include gallstones, hypertriglyceridemia, and, less frequently, alcohol use or idiopathic causes. Diagnosis relies heavily on biochemical markers such as serum amylase and lipase, supported by imaging modalities. Management typically involves conservative treatment; however, obstetric complications may necessitate early delivery. This case highlights a rare instance of acute pancreatitis at 35+5 weeks gestation, complicated by fetal distress, requiring an emergency cesarean section. A multidisciplinary approach involving obstetrics, gastroenterology, and critical care ensured a favorable maternal and neonatal outcome.