Pancreatitis treatment with Lipopheresis in Pregnancy and Outcome
Ayça Sultan Şahin, Ebru Kaya, Murat Ünsel, Nazan Yıldız, Süreyya Özkan, Ziya Salihoğlu,
Sbü Kanuni Sultan Süleyman Eah, Anesteziyoloji Ve Reanimasyon Kliniği, İstanbul
Aim: Acute pancreatitis in pregnancy is rare, occurring in approximately 1/3000 pregnancies. Significant maternal morbidity can occur including intensive care admission, metabolic disturbances, sepsis, pancreatic necrosis, and hypovolemic shock. Rates of preterm delivery, fetal distress, and demise are increased in pregnancies with pancreatitis. Case Report: 21-year-old,19 weeks pregnant woman presented to a emergency service with 4h of abdominal pain that radiates to her back, nausea and vomiting. she doesnt use any medication and cigarettes .she only used folic acid. And she uses vitamin d for 15 weeks. 2 days ago she came to emergency services with Abdominal pain that radiates to her back Nausea. And Vomiting. In biochemistries markers didnt be concluded that lipemic serum and abdominal USG. A radiological and biochemical diagnosis of moderate acute pancreatitis was made. Bloodwork demonstrated prominent lipemic serume. Ketone levels were deemed+3. In abdominal usg:Free fluid was observed around the pancreas. The pancreas wall is edematous and heterogeneous. Appearance is compatible with pancreatitis. There was no known history of diabetes in the patient. She uses only d vitamin and folic asit. Patient transferred intensive care unit support. The patient was consulted with the internal medicine department. Oral stop and lipophoresis are recommended. Management included aggressive rehydration and pain control, and we started lipophoresis, and we repated that lipophoresis three times. At first her bloodworks were lipemic but after first lipophoresis, Bloodwork demonstrated prominent hypertriglyceridaemia(HTG) of 541mg/dl. Conclusion: Patients with acute pancreatitis should be treated with analgesia and fluid resuscitation. Severe hypertriglyceride-induced pancreatitis includes similar management. Lipopheresis may be considered in refractory cases. Preventing severe dyslipidemia in gestation can decrease the risk of pancreatitis and improve maternal and neonatal outcomes. Lipopheresis in acute pancreatitis in perinatal outcomes are likely due to improvements in maternal and perinatal care.
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