Maternal and fetal death associated with acute pancreatitis during pregnancy: A case report

Abstract

BACKGROUND

Acute pancreatitis in pregnancy is a rare but serious condition that can lead to high maternal mortality and fetal loss. Instances of pregnancy complicated by severe acute pancreatitis, particularly with subsequent respiratory and cardiac arrest, are rarely reported.

CASE SUMMARY

We present the case of a 35-year-old woman, at 36 + 5 weeks of gestation, who presented with paroxysmal epigastric pain accompanied by low back pain, nausea, and vomiting. According to the clinical symptoms, B-ultrasound imaging and biochemical indicators, the patient was diagnosed with acute pancreatitis and initially managed conservatively. However, 3 hours after admission, the patient experienced respiratory and cardiac arrest, and the fetus died. In this case, the adverse outcomes occurred due to the lack of aggressive fluid resuscitation and an active surgical intervention.

CONCLUSION

Implementing aggressive fluid resuscitation to sustain tissue perfusion, alongside the proactive evaluation of pharmacological agents that suppress gastric acid secretion and inhibit pancreatic enzyme activity, may be beneficial in mitigating the risk of a severely adverse prognosis. Effective management of acute pancreatitis during pregnancy requires careful timing of surgical intervention, a thorough evaluation of the risks and benefits regarding the continuation or termination of pregnancy, and a focus on safeguarding both maternal and fetal health.

Keywords: Severe acute pancreatitis; Pregnancy; Cardiac arrest; Fetal death; Case report

Core Tip: Acute pancreatitis during pregnancy is an infrequent occurrence that can be linked to significant maternal and fetal mortality. The incidence of pregnancy complicated by severe acute pancreatitis accompanied by respiratory and cardiac arrest is particularly rare. This case report aims to examine the complex decision-making process involved in evaluating surgical interventions and determining the continuation or termination of pregnancy, with an emphasis on safeguarding the health of both the mother and fetus. Proactive and intensive management is crucial to prevent potentially catastrophic outcomes.