Clinical Analysis Of Acute Pancreatitis In Pregnancy

Objective:To explore the aetiological agent,clinical characteristics,laboratory results and recurrence rate of acute pancreatitis in pregnancy,so as to provide reference for the prevention,diagnosis and treatment of acute pancreatitis in pregnancy.Methods:We enrolled female patients with acute pancreatitis who were treated in our department from January 2012 to November 2018 and divided them into two groups.The first group(APIP group): 89 cases of pregnancy with acute pancreatitis;the second group(non-APIP group): 126 cases of non-pregnant women with acute pancreatitis.The aetiological agent,severity,laboratory results and recurrence rate of acute pancreatitis in pregnant and non-pregnant women who suffer from acute pancreatitis were compared and analyzed.(Data processing with SPSS21 software).Results:1.Aetiological agent: common are hypertriglyceridemia,biliary diseases,overeating,and other(trauma,unknown cause).In APIP group,53 cases(59.55%)were hypertriglyceridemia,19 cases(21.35%)were biliary diseases,12 cases(13.48%)were overeating,and 5 cases(5.62%)were other diseases.In the non-APIP group,32 cases(25.40%)were hypertriglyceridemia,45 cases(35.71%)were biliary diseases,29 cases(23.02%)were overeating,and 20 cases(15.87%)were other diseases.There were significant differences in hypertriglyceridemia,biliary diseases and other aetiological agent(trauma,unknown factors,etc.)between the two groups,but there was no statistical difference in overeating.2.Clinical features: In APIP group,there were 4 cases(4.49%)in early pregnancy,23 cases(25.84%)in mid-pregnancy,59 cases(66.29%)in late pregnancy and 3 cases(3.37%)in puerperium.There were 13 cases of mild acute pancreatitis(14.61%),35 cases of moderate severe acute pancreatitis(39.33%)and 41 cases of severe acute pancreatitis(46.07%).In non-APIP group,62 cases(49.21%)were mild acute pancreatitis,35 cases(27.78%)were moderate severe acute pancreatitis and 29 cases(23.02%)were severe acute pancreatitis.There were statistical differences in the proportion of mild and severe acute pancreatitis between the two groups,but there was no statistical difference in the proportion of moderate severe acute pancreatitis.3.Laboratory indicators: Leukocyte count of two groups had statistical difference(P < 0.05).Leukocyte elevation in APIP group was significantly higher than that in non-APIP group.There was significant difference in hemoglobin between the two groups(P<0.05).The severity of anemia in APIP group was higher than that in non-APIP group.There were significant differences in triglyceride and total cholesterol levels between the two groups(P< 0.05).The levels of triglyceride and total cholesterol in APIP group were significantly higher than those in non-APIP group.There was no significant difference in C-reactive protein,calcium ion,fasting blood sugar and glycosylated hemoglobin between the two groups(P > 0.05).4.Recurrence rate: Of 89 cases in APIP group,86 cases completed follow-up,21 cases(24.42%)had pancreatitis recurrence,Among 126 cases in non-APIP group,118 cases completed follow-up,of which 63 cases(53.39%)had pancreatitis recurrence.The recurrence rate of pancreatitis between the two groups was statistically different.Conclusions:Hypertriglyceridemia is the most important aetiological agent for acute pancreatitis in pregnancy,while biliary disease is the most important aetiological agent for non-pregnant patients with acute pancreatitis.Acute pancreatitis during pregnancy is the most common complication in late pregnancy,and the severity of the disease was higher than that of non-pregnant patients with acute pancreatitis.The recurrence rate of pancreatitis after treatment of pregnancy with acute pancreatitis is lower than that of non-pregnant women who suffer from acute pancreatitis.