Pregnancy acute pancreatitis treatment and prognosis

Non-pregnancy and pregnancy treatment of acute pancreatitis in principle basically the same, but as the merger obstetric problems, also in the treatment of non-pregnancy is different from the characteristics. The appropriate obstetric and surgical treatment of acute pancreatitis during pregnancy perinatal outcome good, recent studies have suggested that the maternal mortality only 3.4%, fetal survival rate of 89%.
1. Conservative treatment: acute pancreatitis during pregnancy mainly to conservative treatment, and demanded the Intensive Care Unit for treatment. The purpose is conservative treatment by reducing the synthesis of the pancreatic trypsin to rest, including: fasting, gastrointestinal decompression, use only acid-water and electrolytes such as intravenous added.
2. Endoscopic therapy: gallstone pancreatitis treatment is the first choice Oddi's endoscopic sphincterotomy (EST), or placed nasobiliary drainage. In severe pancreatitis 72 h experts endoscopic treatment, complications (18%) and mortality (0%) were significantly lower than conservative treatment (54% and 13%), but must endoscopic therapy in the early implementation, once the pancreatic tissue necrosis, lesions will be irreversible.
3. Surgical treatment: Pregnancy Surgical treatment of acute pancreatitis limited role, but if conservative treatment of patients with poor response to the surgery is necessary. Its surgical treatment includes two aspects, including surgery on the pancreas itself, but also with pancreatitis related biliary disease surgery. Acute pancreatitis during pregnancy the best operative in the mid-pregnancy or postpartum. Mid-pregnancy surgery safer because in this period of fetal organ development has been completed, spontaneous abortion and the possibility of premature smaller Moreover, the uterus has not entered the abdominal cavity, the surgical field of small and surgery to improve symptoms in patients after the extension of the purposes, the mortality rate in patients with acute surgical higher. Late pregnancy actively advocating conservative treatment, surgery to arrange delivery after, but if abdominal pain exacerbated, serum amylase continued to rise may also laparotomy. Abdominal surgery is not the best time for cesarean section, or unless the case of obstetric indications of increased uterine surgery operation impact.
4. Obstetric addressed: Pregnancy Treatment of severe acute pancreatitis whether to terminate the pregnancy is a debatable issue. There are authors that fetal death, premature birth, or after cesarean section, pancreatitis symptoms can be alleviated. But recently some reports held that the state of patients after childbirth instead of worse. For most patients, acute pancreatitis is not a therapeutic abortion, induction of labor and delivery of the indication. Treatment of acute pancreatitis during pregnancy success, fetal and newborn survival rate is an important indicator, the timely appropriate surgical treatment of acute pancreatitis during pregnancy rate of pregnancy loss is a great degree of decline in termination of pregnancy have to be alert when gestational age and intrauterine fetal whether there are signs of distress.