Obstet Gynecol Sci.  2016 Mar;59(2):148-151. 10.5468/ogs.2016.59.2.148.

Hypertriglyceridemia-induced acute pancreatitis in pregnancy causing maternal death

• Jeon HR
• Kim SY
• Cho YJ
• Chon SJ

• KMID: 2159011
• DOI: http://doi.org/10.5468/ogs.2016.59.2.148

Abstract

Acute pancreatitis in pregnancy is rare and occurs in approximately 3 in 10,000 pregnancies. It rarely complicates pregnancy, and can occur during any trimester, however over half (52%) of cases occur during the third trimester and during the post-partum period. Gallstones are the most common cause of acute pancreatitis. On the other hand, acute pancreatitis caused by hypertriglyceridemia due to increase of estrogen during the gestational period is very unusual, but complication carries a higher risk of morbidity and mortality for both the mother and the fetus. We experienced a case of pregnant woman who died of acute exacerbation of hypertriglyceridemia-induced acute pancreatitis at 23 weeks of gestation. We report on progress and management of this case along with literature reviews.

Keyword

Acute pancreatitis; Hypertriglyceridemia; Maternal death; Pregnancy

MeSH Terms

Estrogens
Female
Fetus
Gallstones
Hand
Humans
Hypertriglyceridemia
Maternal Death*
Mortality
Mothers
Pancreatitis*
Pregnancy Trimester, Third
Pregnancy*
Pregnant Women
Estrogens

Reference

1. Eddy JJ, Gideonsen MD, Song JY, Grobman WA, O'Halloran P. Pancreatitis in pregnancy. Obstet Gynecol. 2008; 112:1075–1081.

2. Montgomery WH, Miller FC. Pancreatitis and pregnancy. Obstet Gynecol. 1970; 35:658–664.

3. Ducarme G, Maire F, Chatel P, Luton D, Hammel P. Acute pancreatitis during pregnancy: a review. J Perinatol. 2014; 34:87–94.

4. Nanda S, Gupta A, Dora A, Gupta A. Acute pancreatitis: a rare cause of acute abdomen in pregnancy. Arch Gynecol Obstet. 2009; 279:577–578.

5. Yadav D, Pitchumoni CS. Issues in hyperlipidemic pancreatitis. J Clin Gastroenterol. 2003; 36:54–62.

6. Whitcomb DC, Gorry MC, Preston RA, Furey W, Sossenheimer MJ, Ulrich CD, et al. Hereditary pancreatitis is caused by a mutation in the cationic trypsinogen gene. Nat Genet. 1996; 14:141–145.

7. Nagayama M, Watanabe Y, Okumura A, Amoh Y, Nakashita S, Dodo Y. Fast MR imaging in obstetrics. Radiographics. 2002; 22:563–580.

8. Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, et al. Classification of acute pancreatitis: 2012. Revision of the Atlanta classification and definitions by international consensus. Gut. 2013; 62:102–111.

9. Gan SI, Edwards AL, Symonds CJ, Beck PL. Hypertriglyceridemia-induced pancreatitis: a case-based review. World J Gastroenterol. 2006; 12:7197–7202.

10. Havel RJ. Pathogenesis, differentiation and management of hypertriglyceridemia. Adv Intern Med. 1969; 15:117–154.

11. Kimura W, Mossner J. Role of hypertriglyceridemia in the pathogenesis of experimental acute pancreatitis in rats. Int J Pancreatol. 1996; 20:177–184.

12. Choi HS, Park JH, Kim JY, Im MW, Lee BI, Lee WY. Hypertriglyceridemia induced acute pancreatitis in pregnancy. Korean J Obstet Gynecol. 2008; 51:1514–1518.

13. Kang JY, Choi GY, Jeong HS, Lee DS, Joo HJ, Bae IH, et al. Hypertriglyceridemia-induced acute pancreatitis in pregnancy: a case report. Korean J Med. 2009; 77:104–108.

14. Kim GH, Jun HA, Song JE, Lee KY, Kim SS. A case of acute pancreatitis induced by hypertriglyceridemia in gestational diabetes. Korean J Obstet Gynecol. 2010; 53:535–539.