Acute pancreatitis in pregnancy commonly results from gallstones, obstruction of the pancreatic duct, and hypertriglyceridemia.

• A. True
• B. False
• C. Only hypertriglyceridemia
• D. Only gallstones

Answer: (A)

Pancreatitis during pregnancy is most commonly linked to biliary disease and lipid disturbances. Gallstones are a leading cause because estrogen during pregnancy increases cholesterol in bile and slows gallbladder emptying, promoting stone formation; these stones can obstruct the pancreatic duct at the ampulla, triggering pancreatitis. Obstruction of the pancreatic duct, whether by stones or inflammatory edema, prevents pancreatic enzymes from draining and leads to autodigestion of the pancreas. Hypertriglyceridemia is another important factor in pregnancy because high triglyceride levels, driven by hormonal changes, can cause pancreatitis when they become extremely elevated, with chylomicron accumulation and free fatty acid–mediated pancreatic injury.

Because these three etiologies are recognized and frequently seen in pregnant patients with pancreatitis, the statement is true. Other causes exist but these cover the major contributors encountered in obstetric practice.