Maternal and perinatal outcome of acute pancreatitis during pregnancy: a 5 year experience at a tertiary care centre


  • Vishnu Priya KMN Department of Obstetrics and Gynaecology, St. John’s Medical College Hospital, Bangalore, Karnataka, India
  • Sheela CN Department of Obstetrics and Gynaecology, St. John’s Medical College Hospital, Bangalore, Karnataka, India
  • Shruti Banka Department of Obstetrics and Gynaecology, St. John’s Medical College Hospital, Bangalore, Karnataka, India
  • Mahalakshmi T. Department of Obstetrics and Gynaecology, St. John’s Medical College Hospital, Bangalore, Karnataka, India





Background: Acute pancreatitis in pregnancy (APIP) is rare and occurs in approximately 1 in 1000 to 1 in 4000 births. The most common symptom of acute pancreatitis is epigastric pain radiating to the back which is accompanied by nausea, vomiting and fever. The aim of the study was to evaluate the maternal and perinatal outcome of acute pancreatitis during pregnancy.

Methods: Six antenatal mothers identified with acute pancreatitis at St. John’s Medical College Hospital, Bengaluru from June 2011 to March 2016 were followed up in the antenatal, postnatal period and their outcomes were evaluated.

Results: There were six cases of acute pancreatitis, with 11,053 deliveries during this 5 year study. Incidence was 1 in 1831. All patients presented with epigastric pain, vomiting and required repeated episodes of admission. There were 14 episodes of acute pancreatitis in these 6 patients. Pancreatitis was severe in 3 patients, with most attacks occurring in third trimester. Etiology was biliary pancreatitis (gallstones) in 2 patients, preeclampsia in 2, idiopathic 1 and hypertriglyceridemia in one patient. Five patients delivered preterm. There were no abortions, fetal loss, maternal and neonatal mortality.

Conclusions: The course of acute pancreatitis in pregnancy is usually mild and self-limiting. But, it can be rapidly progressive and fulminant with complications like electrolyte imbalance, ARDS and DIC. Most patients delivered preterm. Conservative management till delivery by multidisciplinary team lead to good maternal and perinatal outcome.


Whitten AE, Lorenz RP, Smith JM. Hyperlipidemia-associated pancreatitis in pregnancy managed with fenofibrate. Am J Obstet Gynecol. 2011;117:517-9.

Papadakis EP, Sagianni M, Mikhailidis DP, Mamopoulos A. Acute pancreatitis in pregnancy: an overview. European J Obstet Gynecol Reprod Biol. 2011;159:261-6.

Hua-ping L, Ya-jaun H, Xuan C. Acute pancreatitis in pregnancy: a 6-year single center clinical experience. Chin Med J. 2011;14:2771-5.

Choy CMY, Tam WH, Leung TN. Gestational hyperlipidemic pancreatitis. BJOG. 2002;109:847-8.

Badja N, Troche G, Zazzo JF, Benhamou D. Acute pancreatitis and preeclampsia-eclampsia: a case report. Am J Obstet Gynecol. 1997;176:707-9.

Opatrny L, Michon N, Ray E. Preeclampsia as a cause of pancreatitis: a case report. J Obstet Gynaecol Can. 2004;26:594-5.

Parmar MS. Pancreatic necrosis associated with preeclampsia-eclampsia. JOP. 2004;5:101-4.

Crisan LS, Steidl ET, Rivera-Alsina ME. Acute hyperlipidemic pancreatitis in pregnancy. Am J Obstet Gynecol. 2008;198:57-9.

Al-Haddad M, Wallace MB. Diagnostic approach to patients with acute idiopathic and recurrent pancreatitis, what should be done? World J Gastroenterol. 2008;14:1007-10.

Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng K, Spencer FC. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet. 1974;139:69-81.

Nanda S, Gupta A, Dora A, Gupta A. Acute pancreatitis: a rare cause of acute abdomen in pregnancy. Arch Gynecol Obstet. 2009;279:577-8.

Aytul. Maternal and perinatal outcomes of acute pancreatitis during pregnancy. Gaji Medical Journal. 2012:133-137.

Hernandez A, Petrow MS, Brooks DC, Banks PA, Ashley SW, Tavakkolizadeh A. Acute pancreatitis and pregnancy: A 10-year single center experience. J Gastrointest Surg. 2007;11:1623-7.

Dixon NP, Faddis DM, Silberman H. Aggressive management of cholecystitis during pregnancy. Am J Surg. 1987;154:292-4.

Gurbuz AT, Peetz ME. The acute abdomen in the pregnant patient. Is there a role for laparoscopy? Surg Endosc. 1997;11:98-102.

Cohen-Kerem R, Railton C, Oren D, Lishner M, Koren G. Pregnancy outcome following non-obstetric surgical intervention. Am J Surg. 2005;190:467-73.

Ramin KD, Ramsey PS. Disease of the gallbladder and pancreas in pregnancy. Obstet Gynecol Clin North Am. 2001;28:571-80.

Swisher SG, Hunt KK, Schmit PJ, Hiyama DT, Bennion RS, Thompson JE. Management of pancreatitis complicating pregnancy. Am Surg. 1994;60:759-62.






Original Research Articles