First-trimester pancreatitis. Maternal and neonatal outcome.

OBJECTIVE

To determine the incidence and maternal-fetal outcome of first-trimester pancreatitis at one institution.

STUDY DESIGN

A retrospective study of pancreatitis presenting during the first trimester of pregnancy over a 10-year period at Magee Womens Hospital.

RESULTS

There were 11 cases, for an incidence of 0.1/1,000 live births. There was no maternal mortality. Three patients elected voluntary termination, and eight pregnancies proceeded to term. All delivered at > or = 35 weeks. The mean gestational age was 38.9 +/- 2.1 weeks (mean +/- SD), and mean birth weight was 3,103 +/- 641 g. There were no adverse neonatal outcomes, although one patient had a fetus with severe intrauterine growth retardation. Maternal morbidity and complications were due mainly to gallstone pancreatitis, which was the most commonly identified cause of pancreatitis, and three patients underwent cholecystectomy during pregnancy or the puerperium. No first-trimester pregnancy terminations were performed for medical indications. Pancreatitis tended to recur during the examined pregnancy (mean number of admissions, 2.27 +/- 2.1).

CONCLUSION

Patients should be advised of the relapsing nature of pancreatitis that presents during the first trimester. However, there is a good prognosis for pregnancy outcome.