• Features of early diagnosis and treatment tactics of acute pancreatitis in pregnant women

Features of early diagnosis and treatment tactics of acute pancreatitis in pregnant women

HEALTH OF WOMAN. 2018.5(132):76–80; doi 10.15574/HW.2018.132.76

Golyanovskyi O. V. , Feleshtynskyi Ya. P. , Pavliv T. P. , Goncharenko D. O.
Shupyk National Medical Academy of Postgraduate Education, Kiev
Kyiv Oblast Center for Maternal and Child Health

The frequency of acute pancreatitis during pregnancy is from 1: 1000 to 1:10 000 of deliveries. Biliary pancreatitis complicates the pregnancies from 1: 1500 to 1: 3300. The development of complications is associated with difficulty in diagnosis and late determination of diagnosis.

The objective: improvement of early diagnosis and complex treatment of acute pancreatitis in pregnant women in order to reduce the complications of the mother and the fetus / newborn.

Materials and methods. The analysis of diagnostic results and complex treatment of 123 pregnant women was carried out. The treatment group consisted of 61 pregnant women with acute pancreatitis for the period from 2012–2018, using the developed diagnostic and treatment algorithm and the experimental group included 62 pregnant women, from 2006 to 2012, using traditional methods of treatment and diagnosis.

Results. In the treatment group, when applying the diagnostic and treatment algorithm, 100% of patients had acute pancreatitis at an early stage of the disease, which allowed us to obtain the effect of conservative therapy in 27 (44.3%) pregnant women, in 31 (50.8%) cases with the use of delivery and surgical interventions and avoid postoperative lethality, whereas in the experimental group, the effect of conservative treatment was only in 21 (33.9%) cases, and the mortality rate was 1 (1.6%) with pancreonecrosis. In the experimental group in 26 (41.9%) patients, this diagnosis was established only on day 8 ± 2.1 from the onset of the disease.

Conclusion. The use of a diagnostic and therapeutic algorithm in comparison with traditional methods can diagnose acute pancreatitis in pregnant women at an early stage, reduce the number of pregnancy complications and maternal mortality.

Key words: pregnancy, acute pancreatitis, diagnosis, treatment.

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