Management of XXXX complicating pregnancy.

@entity1 @entity788 @entity3152 @entity5990
Pregnancy complicated by @entity788 may lead to significant fetal and maternal morbidity and mortality. We reviewed the clinical course of 30 @entity1 who developed @entity788 in our institution during pregnancy from 1988 to 1992. @entity788 complicated 0.07 per cent of pregnancies (n = 46,075) during this time period. The etiology was @entity5990 in 22 @entity1 , alcohol in 2 @entity1 , and idiopathic in 6 @entity1 . Average age, multiparity, and symptoms at presentation were similar between @entity1 with @entity5990 (NGSP). All @entity1 were initially treated medically. GSP @entity1 had significantly lower Ranson criteria than NGSP (0.7 vs. 1.9, P < 0.01), but response to initial therapy, need for emergency surgery, fetal outcome, and fetal and maternal mortality (0 per cent) were the same. Twenty-six of 30 @entity1 were successfully treated with conservative management. A significantly higher relapse rate was seen in GSP than NGSP @entity1 before delivery (72% vs. 0%, P < 0.05). These relapses required hospitalization 90 per cent of the time and resulted in 3.9 additional days per @entity1 . Six @entity1 underwent surgery during pregnancy (two in the first trimester and four in the second trimester) without fetal or maternal mortality and with normal birthweights and Apgar scores. No relapses or additional days in hospital were noted in GSP @entity1 following surgery. We recommend that GSP @entity1 presenting in the first or second trimester should, if possible, undergo cholecystectomy in the second trimester when the risk of anesthesia and @entity3152 are the lowest. @entity1 presenting in the third trimester should undergo surgery immediately post-partum.(ABSTRACT TRUNCATED AT 250 WORDS)
