Intra-abdominal pressure in third trimester pregnancy complicated by acute pancreatitis: an observational study

BACKGROUND It is known that intra-abdominal hypertension has high morbidity in acute pancreatitis and has detrimental effects on patients. For third trimester pregnancy complicated by acute pancreatitis, the intra-abdominal pressure may have its own characteristic. This article will discuss this clinical scenario. METHODS This observational study in a cohort group was performed in the surgical intensive care unit of a tertiary hospital. Medical records were reviewed from each acute pancreatitis exactly in third trimester pregnancy. The main statistical methods were Mann-Whitney U test and bivariate Pearson correlation analysis. RESULTS During the study interval, there were totally 17 pregnancies complicated by acute pancreatitis in the third trimester. All cases with moderate or severe acute pancreatitis had intra-abdominal hypertension of mean value of 16.7 mm Hg (range, 12.9-22.0 mm Hg). The intra-abdominal pressure had significant correlation with APACHE II score (r = 0.7456, p = 0.0006), while a negative correlation was showed with the umbilical artery pH value and with 1-min Apgar score (r = -0.8232, p = 0.0005; r = -0.7465, p = 0.0034; respectively). The intra-abdominal pressure of those with live infants was lower than that of those with dead ones (13.78 ± 2.554 vs. 19.84 ± 1.695, p = 0.0019). CONCLUSIONS The incidence of intra-abdominal hypertension seems higher in moderate or severe acute pancreatitis in third trimester pregnancy than the non-pregnant cases but there's no significance in this study. Acute elevated intra-abdominal pressure accounts for great association with mother's serious scenario and fetal mortality.