Defined, low threshold for caesarean section and multidisciplinary team management improves fetal outcome from acute pancreatitis in pregnancy.
Pancreatology
; 23(5): 473-480, 2023 Aug.
Article
em En
| MEDLINE
| ID: mdl-37263836
ABSTRACT
BACKGROUND:
Acute pancreatitis in pregnancy (APIP) is associated with increased maternal and fetal mortality.OBJECTIVES:
We sought to determine whether a low threshold for cesarean section (C-section) in severe acute pancreatitis (SAP) or Predict SAP improves maternal and fetal outcomes in patients with APIP.METHODS:
We identified patients with APIP at a single institution from a prospective database and studied fetal and maternal health in APIP before (2005-2014) and after (2015-2019) introduction of multidisciplinary team management with a defined, lowered threshold for C-section. The primary end point was fetal mortality comprising abortion and perinatal death. Risk factors associated with fetal mortality were analyzed by univariable and multivariable logistic regression analysis.RESULTS:
A total of 165 patients with APIP were eligible for analysis. There was a highly significant increase in patients undergoing C-section from 37 (30.8%) of 120 during 2005-2014 to 27 (60%) of 45 in 2015-2019 (P = 0.001), with a highly significant fall in fetal mortality from 37 (30.8%) of 120 to 3 (6.7%) of 45 between the same periods (P = 0.001), when maternal mortality fell from 6 to zero (P = 0.19). Maternal early systemic inflammatory response syndrome (SIRS) (odds ratio [OR] 6.98, 95% confidence interval [CI] 1.53, 30.80, P = 0.01) and SAP (OR 3.64, 95%CI 1.25, 10.60, P = 0.02) were two independent risk factors associated with fetal mortality.CONCLUSIONS:
Multidisciplinary collaboration and a defined, low threshold for C-section improve fetal outcomes in patients with APIP.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Pancreatite
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article