| Background and aim:Acute pancreatitis in pregnancy is a serious complication of pregnancy, acute onset, rapid progress, such as the treatment is not timely, maternal and perinatal mortality rate is high, a serious threat to maternal and child health. Therefore understanding the pathogenesis of acute pancreatitis during pregnancy causes, mechanism and clinical characteristics, is very important for the treatment and prevention of pregnancy with acute pancreatitis significance. This article summarizes the2003January to2013December in the First Hangzhou People’s Hospital,102cases of acute pancreatitis during pregnancy patients with lipid metabolic characteristics and disease characteristics, attack analysis of serum lipid results with acute pancreatitis during pregnancy and the degree of correlation between the disease, improve the blood lipid of pregnancy characteristics and period of acute pancreatitis during pregnancy cognitive characteristics. Methods:102cases of patients with acute pancreatitis during pregnancy period is divided into early, middle and late groups, each group according to the severity of pancreatitis is divided into mild, moderate and severe group.100cases of normal women of childbearing age and100cases of pregnant women of early, middle and late group,100cases for each group, are randomly selected from the medical centre over the same period as the control group. Characteristics of lipids for each group of hospitalized patients (high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), total cholesterol (TC), triglyceride (TG) are analyzed to determine the relationship between results of blood lipids at different periods of pregnancy and characteristics of pancreatitis.Result:(1) Acute pancreatitis during pregnancy occurring in early, middle and late pregnancy were respectively18.6%(19/102),25.5%(26/102).55.9%(57/102). The percentages according to severity of mild, moderate and severe were49.0%(50/102),40.2%(41/102),10.8%(11/102); occurring in82.4%(84/102) in patients with acute pancreatitis during pregnancy with hyperlipemia (the lever of blood serum triglyceride>1.7mmol/L), the incidence of moderate and severe acute pancreatitis were62.7%(52/83), and hyperlipidemic accouted for moderate acute pancreatitis to severe were84.6%(44/52).(2) During early pregnancy period, there is no difference in lipid level (HDL-C, LDL-C, TC, TG) between mild pancreatits group, normal pregnant group and non-pregnant group (P>0.05). During middle and late pregnancy period, the lipid level of normal pregnant group is higher than the non-pregnant group (P<0.05) and there is no difference between mild pancreatitis group and normal pregnant group (P>0.05). Meanwhile the LDL-C, TC and TG level of the moderate and severe acute pancreatitis group is higher than those of the mild group (P<0.05), among which the TG level is significantly higher than that of the mild group. There is no statistically difference between the moderate group and severe group (P>0.05).(3) There were two cases of mortality for the late pregnancy with severe acute pancreatitis (1.9%). The pregnancy termination rate of middle pregnancy with moderate acute pancreatitis is83.3%(10/12).40cases of late pregnancy with severe acute pancreatitis were terminated by cesarean section with8cases of intrauterine death and death after birth. The perinatal mortality rate is14.0%(8/57).Conclusion:Mild acute pancreatitis during pregnancy may be accompanied by mild hyperlipemia (TG≤5.6mmol/L) and the prognosis has no relationship with lipid level. However, during middle and late pregnancy, significant hyperlipemia is an important cause of moderate and severe acute pancreatitis and maternal death. The pregnancy has to be terminated and the perinatal mortality rate is high. It is very important to control blood lipid (TG<5.6mmol/L) to prevent moderate and severe acute pancreatitis during pregnancy. |
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