Abstract
RATIONALE: Hypertriglyceridemia-induced acute pancreatitis during pregnancy is a rare and severe condition that poses significant risks to both maternal and neonatal health; however, there is a lack of standardized treatment guidelines and restrictions on therapeutic options during pregnancy. PATIENT CONCERNS: We present a case of acute pancreatitis caused by gestational hypertriglyceridemia and conduct a literature review regarding the safety of the primary therapeutic drugs used during pregnancy. DIAGNOSES: A 32-year-old female patient, who was 24 weeks pregnant, experienced postprandial abdominal pain accompanied by nausea and vomiting. A computed tomography scan confirmed the diagnosis of acute pancreatitis, and her serum triglyceride levels were found to be 57.00 mmol/L. INTERVENTIONS: Upon admission to the hospital, the patient's treatment encompassed intravenous hydration, blood filtration, and the administration of octreotide and ulinastatin to suppress the pancreatic secretion of fluid and enzymes. In addition, she underwent lipid-lowering therapy with fenofibrate and ezetimibe. OUTCOMES: The patient recovered and was discharged, with no recurrence of pancreatitis throughout her pregnancy. At 36 + 1 weeks of gestation, the patient underwent a cesarean section due to premature rupture of membranes, inevitable preterm birth, and fetal position right sacrum anterior, delivering a healthy female newborn. LESSONS: The safety evidence for acute pancreatitis treatment drugs such as octreotide, ulinastatin, and lipid-lowering medications during pregnancy is not fully sufficient. However, considering the severity of the disease, which often occurs in the second and third trimesters of pregnancy, cautious use may be warranted when the benefits outweigh the risks.