Yalcin Bahat Pınar, Turan Gokce, Aslan Cetin Berna
Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul Health Sciences University, Istanbul, Turkey.
Case Rep Obstet Gynecol. 2018 Sep 5;2018:3869695. doi: 10.1155/2018/3869695. eCollection 2018.
Hormonal effects during pregnancy can compromise otherwise controlled lipid levels in women with hypertriglyceridemia and predispose to pancreatitis leading to increased morbidity for mother and fetus. Elevation of triglyceride levels is a risk factor for development of pancreatitis if it exceeds 1000 mg/dL. Pancreatitis should be considered in emergency cases of abdominal pain and uterine contractions in Emergency Department at any stage of pregnancy. We report a case of abruptio placentae caused by hypertriglyceridemia-induced acute pancreatitis. Also, literature review of cases of acute pancreatitis induced by hypertriglycaemia in pregnancy has been made.
A 22-year-old woman presented to our Emergency Department, at 35 weeks of gestation, for acute onset of abdominal pain and uterine contractions. Blood tests showed a high rate of triglyceride. The patient was diagnosed with abruptio placentae caused by hypertriglyceridemia-induced acute pancreatitis. Immediate cesarean section was performed and it was observed that blood sample revealed a milky turbid serum. Insulin, heparin, and supportive treatment were started. She was discharged on the 10th day.
Consequently, patients with known hypertriglyceridemia or family history should be followed up more closely because any delay can cause disastrous conclusions for mother and fetus. Acute pancreatitis should be considered in pregnant women who have sudden onset, severe, persistent epigastric pain and who have a risk factor for acute pancreatitis.
孕期激素影响可能使原本血脂控制良好的高甘油三酯血症女性的血脂水平受损,并易引发胰腺炎,导致母婴发病率增加。如果甘油三酯水平超过1000mg/dL,其升高是胰腺炎发生的危险因素。在孕期任何阶段,急诊科遇到腹痛和子宫收缩的紧急情况时都应考虑胰腺炎。我们报告一例由高甘油三酯血症诱发的急性胰腺炎导致的胎盘早剥病例。此外,还对孕期高甘油血症诱发急性胰腺炎的病例进行了文献综述。
一名22岁女性在妊娠35周时因突发腹痛和子宫收缩就诊于我院急诊科。血液检查显示甘油三酯水平很高。该患者被诊断为由高甘油三酯血症诱发的急性胰腺炎导致的胎盘早剥。立即进行了剖宫产,观察到血样显示血清呈乳状浑浊。开始使用胰岛素、肝素及支持治疗。她于第10天出院。
因此,已知患有高甘油三酯血症或有家族病史的患者应进行更密切的随访,因为任何延误都可能给母婴带来灾难性后果。对于突发严重持续性上腹部疼痛且有急性胰腺炎危险因素的孕妇,应考虑急性胰腺炎。