Severe fetal distress and acute maternal pancreatitis secondary to severe hypertriglyceridemia: a case report

Abstract

Abstract Background Acute pancreatitis (AP) during pregnancy is a rare condition and a potential cause of maternal–fetal mortality. Its diagnosis can be challenging. Hypertriglyceridemia (HTG) is one of the causes. We describe a case of severe fetal distress in the third trimester of pregnancy, associated with severe HTG complicated by AP. Case presentation A 35-year-old pregnant patient at 36-week gestation presented to the emergency department with acute epigastric pain. After excluding preeclampsia and initially challenging laboratory analyses, a diagnosis of AP was made based on a lipase level 12 times the normal range. The etiology was HTG at 40 times the normal level. Despite initial conservative management, the patient deteriorated rapidly clinically, and severe fetal distress (SFD) necessitated an emergency cesarean section. Lactescent blood appearance was observed intraoperatively. We suspect that the severe and rapid HTG may have caused acute fetal hypoxia. Conclusions AP during pregnancy is a rare condition, with significant maternal–fetal mortality. Early diagnosis remains challenging. A multidisciplinary approach is necessary for optimal management, with special consideration for rapid fetal delivery in cases of AP secondary to HTG due to the increased risk of fetal mortality.