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gestation pancreatitis acute

Bertha Wong, Teik C Ooi, Erin Keely
Severe gestational hypertriglyceridemia is a potentially life threatening and complex condition to manage, requiring attention to a delicate balance between maternal and fetal needs. During pregnancy, significant alterations to lipid homeostasis occur to ensure transfer of nutrients to the fetus. In women with an underlying genetic predisposition or a secondary exacerbating factor, severe gestational hypertriglyceridemia can arise, leading to devastating complications, including acute pancreatitis. Multidisciplinary care, implementation of a low-fat diet with nutritional support, and institution of a hierarchical therapeutic approach are all crucial to reduce maternal and fetal morbidity...
December 2015: Obstetric Medicine
Laura D Brown, Melissa Davis, Sandra Wai, Stephanie R Wesolowski, William W Hay, Sean W Limesand, Paul J Rozance
Placental insufficiency is associated with reduced supply of amino acids to the fetus and leads to intrauterine growth restriction (IUGR). IUGR fetuses are characterized by lower glucose-stimulated insulin secretion, smaller pancreatic islets with less β-cells, and impaired pancreatic vascularity. To test whether supplemental amino acids infused into the IUGR fetus could improve these complications of IUGR we used acute (hours) and chronic (11 d) direct fetal amino acid infusions into a sheep model of placental insufficiency and IUGR near the end of gestation...
October 2016: Endocrinology
Padmavathi Mali
BACKGROUND: Acute pancreatitis in pregnancy is a rare and dangerous disease. This study aimed to examine the etiology, treatment, and outcomes of pancreatitis in pregnancy. METHOD: A total of 25 pregnant patients diagnosed with pancreatitis during the period of 1994 and 2014 was analyzed retrospectively. RESULTS: The pregnant patients were diagnosed with pancreatitis during a period of 21 years. Most (60%) of the patients were diagnosed with pancreatitis in the third trimester...
August 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
D Saldivar-Rodríguez, O R Treviño-Montemayor, A Guzmán-López, G Treviño-Martínez, C C Flores-Acosta
BACKGROUND: Acute pancreatitis is an inflammatory disease that affects the pancreatic tissue, which have been proposed numerous causes, with unpredictable results, it appears as a complication of rare occurrence, so the information on maternal and fetal complications is limited. Objective: Exposing obstetric and perinatal outcomes of patients diagnosed with pancreatitis complicating pregnancy. METHODOLOGY: A retrospective, observational, transverse and descriptive study; data were obtained and analyzed by reviewing medical records of patients diagnosed with pancreatitis and pregnancy...
February 2016: Ginecología y Obstetricia de México
Gina N Woods, Alec Saitman, Hanlin Gao, Nigel J Clarke, Robert L Fitzgerald, Nai-Wen Chi
The CYP24A1 gene encodes a mitochondrial 24-hydroxylase that inactivates 1,25(OH)2 D. Loss-of-function mutations in CYP24A1 cause hypercalcemia, nephrolithiasis and nephrocalcinosis. We describe a woman with CYP24A1 deficiency and recurrent gestational hypercalcemia. Her first pregnancy, at age 20, resulted in the intrauterine demise of twin fetuses. Postpartum, she developed severe hypercalcemia (14 mg/dL), altered mental status, and acute pancreatitis. Her PTH was suppressed (6 pg/mL) and her 1,25(OH)2 D was elevated (165 and 195 pg/mL on postpartum day 1 and 5, respectively)...
April 22, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Hae Rin Jeon, Suk Young Kim, Yoon Jin Cho, Seung Joo Chon
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...
March 2016: Obstetrics & Gynecology Science
Chunlan Huang, Jie Liu, Yingying Lu, Junjie Fan, Xingpeng Wang, Jun Liu, Wei Zhang, Yue Zeng
AIMS: To analyze the features and treatment of hypertriglyceridemia-induced acute pancreatitis (HTGP) during pregnancy. METHODS: A retrospective study of 21 pregnant women diagnosed with acute pancreatitis (AP) was performed. Patients were divided into acute biliary pancreatitis (ABP), HTGP, and idiopathic groups according to etiology. RESULTS: 95% of the patients were in the third trimester of gestation. The percentage of patients with HTGP was higher than that of ABP (48% vs...
March 4, 2016: Journal of Clinical Apheresis
Tomomi Hara, Haruhiko Kanasaki, Aki Oride, Tomoko Ishihara, Satoru Kyo
Acute pancreatitis is rare in pregnancy, with an estimated incidence of approximately 1 in 1000 to 1 in 10,000 pregnancies. Acute pancreatitis in pregnancy usually occurs in the third trimester. Here, we report a case of acute pancreatitis in the first trimester. A 36-year-old primigravida at 11 weeks of gestation complained of severe lower abdominal pain. The pain gradually worsened and migrated toward the epigastric region. She had no history of chronic alcoholism. Blood investigations showed elevated level of C-reactive protein (9...
2015: Case Reports in Obstetrics and Gynecology
Florent Marguet, Annie Laquerrière, Alice Goldenberg, Anne-Marie Guerrot, Olivier Quenez, Philippe Flahaut, Catherine Vanhulle, Clémentine Dumant-Forest, Françoise Charbonnier, Myriam Vezain, Soumeya Bekri, Isabelle Tournier, Thierry Frébourg, Gaël Nicolas
We describe the case of a young patient with calcifying encephalopathy, born to asymptomatic parents. An extensive hypothesis-driven etiological assessment was performed and failed to detect the precise etiology during many years. We therefore decided to perform whole exome sequencing of the child-unaffected parents trio. A de novo pathogenic variant in the IFIH1 gene which has recently been shown to cause autosomal dominant forms of Aicardi-Goutières syndrome was identified. This child presented with a severe form with neonatal thrombocytopenia and hepatomegaly, the latter having been detected during late gestation...
May 2016: American Journal of Medical Genetics. Part A
Mousa Talebi-Bakhshayesh, Alireza Mohammadzadeh, Ali Zargar
Acute pancreatitis is one of the most common diseases of the gastrointestinal tract and is usually caused by gallstones; its occurrence in pregnancy is rare. Cholecystectomy for biliary pancreatitis during pregnancy is unavoidable, but its timing is controversial. We herein present the case of a patient who underwent termination of pregnancy due to deteriorated acute severe pancreatitis during the 27th week of gestation. Cholecystectomy was performed because of the relapse of acute biliary pancreatitis 10 days after being discharged...
May 2015: Malaysian Journal of Medical Sciences: MJMS
Victoria Contreras-Bolívar, Inmaculada González-Molero, Pedro Valdivieso, Gabriel Olveira
We present a case of severe acute pancreatitis induced by hypertriglyceridemia secondary to lipoprotein lipase (LPL) deficiency in a pregnant patient with gestational diabetes, initially maneged with diet but it was later necessary to carry out artificial nutricional support measures: total parenteral nutrition. LPL deficiency might cause severe hypertriglyceridemia, repetition acute pancreatitis which is an unwieldy and severe situation during pregnancy. Acute familial hypertriglyceridemia pancreatitis accounts for 5% of cases, including LPL deficiency...
2015: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
Teng Zuo, Jia Yu, Wei-Xing Wang, Kai-Liang Zhao, Chen Chen, Wen-Hong Deng, Xiao-Bo He, Peng Wang, Qiao Shi, Wen-Yi Guo
OBJECTIVES: To establish a rat model of acute pancreatitis in pregnancy (APIP) and evaluate its general presentations, assess placental injury, and discuss possible mechanisms. METHODS: The APIP rat model was induced by sodium taurocholate in Sprague-Dawley rats of later gestation. Normal and sham-operated (SO) rats in later gestation were set as controls, 3 time points were set in SO and APIP groups to determine optimal modeling time. Histological changes of pancreas and placenta were assessed...
July 2016: Pancreas
Mary Ashley Cain, Jeremy Ellis, Marc A Vengrove, Benjamin Wilcox, Jerome Yankowitz, John C Smulian
IMPORTANCE: Patients with biliary disease or underlying dyslipidemias are at risk for pancreatitis in pregnancy. Appropriate treatment can decrease the risk of recurrence and perinatal complications. Prevention of severe lipid elevations can prevent the development of pancreatitis in pregnancy. OBJECTIVE: To review the pathophysiology, diagnosis and treatment of gallstone and severe hypertriglyceride-induced pancreatitis in pregnancy. EVIDENCE ACQUISITION: We performed a literature search regarding pancreatitis, gallstones, hyperlipidemia, and the treatment of both severe hypertriglyceride-induced pancreatitis and gallstone pancreatitis in pregnancy...
September 2015: Obstetrical & Gynecological Survey
Piers R Blackett, Don P Wilson, Catherine J McNeal
Secondary dyslipidemia with predominant hypertriglyceridemia may occur as a consequence of both common and rare causes. After accounting for obesity and associated insulin resistance, clinicians should carefully consider other contributing factors and conditions. Genetic background and causative factors prevail during gestation, infancy, and childhood and continue in adults. Elevations in triglyceride (TG) are associated with transfer of TG to high-density lipoprotein (HDL) and low-density lipoprotein (LDL) resulting in lipolysis, HDL degradation, and formation of atherogenic LDL particles...
September 2015: Journal of Clinical Lipidology
N F Khvorostukhina, L A Salov, D A Novichkov
The study included 78 pregnant women with acute pancreatiis. Group 1 contained 43 4-37 weeks pregnant women and group 2 35 non-pregnant women. Control group was comprised of 30 women with physiological pregnancy. Comparative analysis of peculiarities of the clinical course of acute pancreatitis showed its similar manifestations in all three groups. However pregnancy itself variability of pancreatitis symptoms and their similarity to those of other acute surgical and obstetric pathologies, high (25.6) percent ofpainlessforms, late detection and inadequate treatment pose difficultiesfor diagnostics and delay the onset of pathogenetic therapy...
2015: Klinicheskaia Meditsina
Ashvin Paramanathan, Sam Zachary Walsh, Jieyun Zhou, Steven Chan
INTRODUCTION: Biliary tract disease is a common non-obstetric surgical presentation during pregnancy. Although small international series demonstrate favourable outcomes following laparoscopic cholecystectomy (LC) during pregnancy, there is a paucity of Australian data to complement these findings. METHOD: Between 1st January 2003 and 30th June 2013, all patients undergoing planned LC during pregnancy at Western Health were retrospectively identified. RESULTS: Twenty-two patients underwent planned LC with 3 (13%) cases converted to open surgery...
June 2015: International Journal of Surgery
Nicola English, Jegajeeva Rao
We present the case of a 33-year-old woman in her first pregnancy. She presented with pruritus at 34 weeks gestation. A diagnosis of intrahepatic cholestasis of pregnancy was made based on elevated bile acids and elevated liver transaminases. She re-presented 4 days later, jaundiced with abdominal pain and nausea, and was hypertensive. Her bilirubin was now elevated and her creatinine had doubled. The differential diagnosis-included pre-eclampsia and Hemolysis Elevated Liver enzymes Low Platelet count (HELLP) syndrome, and delivery was expedited...
2015: BMJ Case Reports
E Nash, P Ranka, G Tarigopula, T Rashid
Primary hyperparathyroidism is rare during pregnancy. Recognition may be challenging as symptoms overlap with those of other common disorders of pregnancy. Furthermore, physiological changes of pregnancy affecting calcium homoeostasis mean awareness of the condition and careful interpretation of results in the light of pregnancy are essential for diagnosis. Maternal complications of primary hyperparathyroidism include nephrolithiasis, pancreatitis, cardiac arrhythmias, hypertension and peptic ulcers. At its most severe, hypercalcaemic crisis may occur, presenting with acute neurological disturbance...
2015: BMJ Case Reports
Bahiyah Abdullah, Thanikasalam Kathiresan Pillai, Lim Huay Cheen, Ray Joshua Ryan
This is a case of a pregnant lady at 8 weeks of gestation, who presented with acute abdomen. She was initially diagnosed with ruptured ectopic pregnancy and ruptured corpus luteal cyst as the differential diagnosis. However she then, was finally diagnosed as acute hemorrhagic pancreatitis with spontaneous complete miscarriage. This is followed by review of literature on this topic. Acute pancreatitis in pregnancy is not uncommon. The emphasis on high index of suspicion of acute pancreatitis in women who presented with acute abdomen in pregnancy is highlighted...
2015: Case Reports in Obstetrics and Gynecology
Ji Yeon Kim, Sung Hoon Jung, Hyung Wook Choi, Dong Jin Song, Cheol Yoon Jeong, Dong Hyun Lee, Il Soon Whang
Acute pancreatitis during pregnancy is a rare event, and can be associated with high maternal mortality and fetal loss. Gallstone disease is thought to be the most common causative factor of acute pancreatitis, but, in many cases, the cause remains unclear. We report a case of a 36-year-old woman at 35 wk of gestation, who presented with severe pain confined to the upper abdomen and radiating to the back. The patient was diagnosed with acute idiopathic pancreatitis, which was managed conservatively; she recovered within several days and then delivered a healthy baby...
November 21, 2014: World Journal of Gastroenterology: WJG
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