{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T22:47:16Z","timestamp":1787698036949,"version":"build-2784847793"},"reference-count":17,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Acute pancreatitis in pregnancy and the early postpartum period (APIP) is an uncommon but potentially life-threatening condition associated with significant maternal morbidity. Physiological adaptations of pregnancy, recent obstetric surgery, and overlapping postoperative symptoms frequently obscure early diagnosis and complicate perioperative and critical care management. This review provides a clinically oriented, anaesthesiology-focused overview of APIP, integrating current evidence with perioperative decision-making, pain management strategies, and intensive care considerations relevant to obstetric practice. Methods: A narrative, clinically structured review of the literature was performed focusing on epidemiology, aetiology, diagnosis, severity stratification, and management of APIP. Anaesthesiology- and ICU-specific aspects are synthesised into a pragmatic management framework. Results: Gallstone disease and hypertriglyceridaemia remain the predominant causes of APIP, with most cases occurring in the third trimester or early postpartum period. Diagnosis relies on pancreatic enzyme elevation and pregnancy-adapted imaging strategies. Early goal-directed fluid resuscitation, effective multimodal analgesia, and timely initiation of enteral nutrition are key determinants of outcome. Therapeutic ERCP and laparoscopic cholecystectomy can be safely performed during pregnancy when clinically indicated and may reduce recurrence in biliary pancreatitis. Neuraxial analgesia provides effective, opioid-sparing pain control and may improve respiratory mechanics and haemodynamic stability. Persistent organ failure remains the strongest predictor of adverse outcome and should prompt early intensive care admission. Conclusions: APIP requires early recognition and severity-adapted, multidisciplinary management. Anaesthesiology-led strategies play a central role in optimising analgesia, haemodynamic stability, and timely escalation of care. Framing APIP within a perioperative and critical care context may improve maternal outcomes in this vulnerable patient population.<\/jats:p>","DOI":"10.3390\/jcm15082968","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T10:29:08Z","timestamp":1776162548000},"page":"2968","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Acute Pancreatitis in Pregnancy and the Early Postpartum Period: An Anaesthesiology and Critical Care Perspective"],"prefix":"10.3390","volume":"15","author":[{"given":"Krisztina","family":"T\u00f3th","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Intensive Therapy, University of P\u00e9cs Medical School, 7624 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zsombor","family":"M\u00e1rton","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, University of P\u00e9cs Medical School, 7624 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5605-8370","authenticated-orcid":false,"given":"Csaba","family":"Csontos","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Therapy, University of P\u00e9cs Medical School, 7624 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7234-6383","authenticated-orcid":false,"given":"S\u00e1ndor","family":"M\u00e1rton","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Therapy, University of P\u00e9cs Medical School, 7624 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1038\/jp.2013.161","article-title":"Acute pancreatitis during pregnancy: A review","volume":"34","author":"Ducarme","year":"2014","journal-title":"J. Perinatol."},{"key":"ref_2","first-page":"2010","article-title":"Acute pancreatitis in pregnancy and its impact on maternal and fetal outcomes","volume":"22","author":"Singh","year":"2022","journal-title":"Pancreatology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3672","DOI":"10.1007\/s10620-011-1809-5","article-title":"Severe acute pancreatitis during pregnancy: Eleven years\u2019 experience from a surgical intensive care unit","volume":"56","author":"Geng","year":"2011","journal-title":"Dig. Dis. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.ijsu.2019.09.016","article-title":"Challenges encountered in the management of gallstone-induced pancreatitis in pregnancy","volume":"71","author":"Samaraee","year":"2019","journal-title":"Int. J. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1002\/hep.20534","article-title":"Incidence, natural history, and risk factors for biliary sludge and stones during pregnancy","volume":"41","author":"Ko","year":"2005","journal-title":"Hepatology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1159\/000242614","article-title":"Lipoprotein metabolism in pregnancy, fat transport to the fetus, and the effects of diabetes","volume":"50","author":"Knopp","year":"1986","journal-title":"Biol. Neonate"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"161","DOI":"10.4166\/kjg.2016.68.3.161","article-title":"Idiopathic severe acute pancreatitis following cesarean section","volume":"68","author":"Kim","year":"2016","journal-title":"Korean J. Gastroenterol."},{"key":"ref_8","first-page":"1231","article-title":"Acute pancreatitis following cesarean section","volume":"164","year":"2023","journal-title":"Orv. Hetil."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1002\/bjs.5290","article-title":"Association between early systemic inflammatory response, severity of multiorgan dysfunction and death in acute pancreatitis","volume":"93","author":"Mofidi","year":"2006","journal-title":"Br. J. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1136\/gut.2004.039883","article-title":"Persistent organ failure during acute pancreatitis as a marker of severity","volume":"53","author":"Johnson","year":"2004","journal-title":"Gut"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/j.gie.2008.05.024","article-title":"Safety and utility of ERCP during pregnancy","volume":"69","author":"Tang","year":"2009","journal-title":"Gastrointest. Endosc."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1136\/gutjnl-2012-302779","article-title":"Classification of acute pancreatitis\u20142012: Revision of the Atlanta classification","volume":"62","author":"Banks","year":"2013","journal-title":"Gut"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"778","DOI":"10.2214\/AJR.11.7405","article-title":"Imaging of pregnant and lactating patients: Evidence-based review and recommendations","volume":"198","author":"Wang","year":"2012","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.clnu.2020.01.004","article-title":"ESPEN guideline on clinical nutrition in acute and chronic pancreatitis","volume":"39","author":"Arvanitakis","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"9367","DOI":"10.3748\/wjg.v21.i31.9367","article-title":"Fluid resuscitation in acute pancreatitis: Normal saline or lactated Ringer\u2019s solution?","volume":"21","author":"Lipinski","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1803","DOI":"10.1002\/ueg2.70121","article-title":"Safety and Effectiveness of Cholecystectomy and Endoscopic Retrograde Cholangiopancreatography in Biliary Pancreatitis During Pregnancy: BORN Study","volume":"13","author":"Szalai","year":"2025","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Qiu, X., Zhang, B., He, S., Huang, F., Chen, N., Liang, S., Zhu, L., Qin, M., Liang, Z., and Huang, J. (2025). Development of a novel nomogram to predict the prognosis of acute pancreatitis in pregnancy. BMC Gastroenterol., 25.","DOI":"10.1186\/s12876-025-04414-9"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/8\/2968\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T10:56:28Z","timestamp":1776164188000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/8\/2968"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,14]]},"references-count":17,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["jcm15082968"],"URL":"https:\/\/doi.org\/10.3390\/jcm15082968","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,14]]}}}