title: Gallstone and Severe Hypertriglyceride-Induced Pancreatitis in Pregnancy.
abstract: OBJECTIVE
  Patients with biliary disease or underlying dyslipidemias are at risk for pancreatitis in pregnancy. Appropriate treatment can decrease the risk of recurrence and perinatal complications. Prevention of severe lipid elevations can prevent the development of pancreatitis in pregnancy.
  
  
  OBJECTIVE
  To review the pathophysiology, diagnosis and treatment of gallstone and severe hypertriglyceride-induced pancreatitis in pregnancy.
  
  
  METHODS
  We performed a literature search regarding pancreatitis, gallstones, hyperlipidemia, and the treatment of both severe hypertriglyceride-induced pancreatitis and gallstone pancreatitis in pregnancy.
  
  
  RESULTS
  In the setting of acute pancreatitis, removal of the offending agent, either gallstones or serum lipids, can lead to improved status and decrease recurrence risk.
  
  
  CONCLUSIONS
  Patients with acute pancreatitis should be treated with analgesia and fluid resuscitation and maintain a nothing-per-os status. In cases of gallstone pancreatitis, removal of the offending stone through endoscopic retrograde cholangiopancreatography or cholecystectomy can decrease recurrence risk. Severe hypertriglyceride-induced pancreatitis includes similar management. Lipopheresis may be considered in refractory cases. Patients with severe hypercholesterolemia should maintain a low-fat diet and can continue lipid-lowering agents outside the statin class of medications. Preventing severe dyslipidemia in gestation can decrease the risk of pancreatitis and improve maternal and neonatal outcomes.
authors.affiliation: Fellow, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL.
authors.forename: Mary Ashley
authors.initials: MA
authors.lastname: Cain
authors.affiliation: Clinical Assistant Professor, Department of Internal Medicine, Thomas Jefferson University, Philadelphia.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Ellis
authors.affiliation: Chief, Division of Endocrinology and Metabolism, Department of Internal Medicine, Lehigh Valley Health, Allentown, PA.|Clinical Assistant Professor, Division of Endocrinology andMetabolism, Morsani College of Medicine, University of South Florida, Tampa, FL.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Vengrove
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Lehigh Valley Health Network, Allentown, PA.|Clinical Assistant Professor of Medicine.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Wilcox
authors.affiliation: Professor and Chairman, Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL.
authors.forename: Jerome
authors.initials: J
authors.lastname: Yankowitz
authors.affiliation: Vice Chair, Department of Obstetrics and Gynecology, Lehigh Valley Health Network, Allentown, PA.|Professor, Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL.
authors.forename: John C
authors.initials: JC
authors.lastname: Smulian
mesh_terms: D000208:Acute Disease; D000328:Adult; D000698:Analgesia; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy; D005260:Female; D005440:Fluid Therapy; D042882:Gallstones / Q000150:complications* / Q000601:surgery; D006801:Humans; D015228:Hypertriglyceridemia / Q000150:complications* / Q000628:therapy; D010195:Pancreatitis / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D012008:Recurrence