Perioperative nursing care for a parturient with hypertriglyceridemic acute pancreatitis undergoing cesarean section: A case report

高甘油三酯血症性急性胰腺炎产妇行剖宫产术的围手术期护理:病例报告

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Abstract

RATIONALE: Diagnosing hypertriglyceridemic acute pancreatitis (HTG-AP) in a parturient is challenging due to pregnancy-related physiological changes, and its treatment is fraught with complexities. This single-patient case report serves as a valuable resource for nursing practice of a parturient with HTG-AP and contributes to the formulation of relevant guidelines for this condition. PATIENT CONCERNS: The patient was a 32-year-old woman with a history of 5 pregnancies and 1 live birth, and her last menstrual period was on November 13, 2024. At 29 weeks and 4 days of pregnancy, she was transferred from the obstetrics department to the intensive care unit (ICU) due to HTG-AP for treatment. DIAGNOSES: The patient was diagnosed with HTG-AP. INTERVENTIONS: With maternal and infant safety as the core, a multidisciplinary team collaborates to balance the timing of cesarean section and the treatment of pancreatitis, simultaneously monitoring fetal distress, uterine contractions, and maternal metabolism, and precisely implementing plasma exchange and insulin therapy. Strengthen perioperative airway management to prevent acute respiratory distress syndrome and atelectasis, and provide full-course psychological support and health guidance. OUTCOMES: After 5 days of treatment in the ICU, the patient was transferred to the operating room for a cesarean section. The operation was successful and a baby girl was delivered. The newborn was transferred to the pediatric department for further treatment. The mother was then returned to the ICU for continued treatment after the operation. On the fourth day after delivery, the patient's vital signs were stable and she was transferred back to the obstetrics department for further treatment. LESSONS: Multidisciplinary joint care plays a crucial role in the treatment of pregnancy complicated with HTG-AP. In the future, it is necessary to further explore the standardized nursing pathway for HTG-AP during pregnancy and strategies for improving long-term maternal and infant outcomes.

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