Viêm tụy cấp do tăng Triglyceride máu ba tháng cuối thai kỳ: Đặc điểm lâm sàng, cận lâm sàng và các yếu tố dự báo tiên lượng nặng

Abstract

We conducted a retrospective cross-sectional study including all 41 women in the third trimester diagnosed with hypertriglyceridemia-induced acute pancreatitis (HTG-AP) and treated at Bach Mai Hospital from September 2018 to October 2024. Disease severity was classified according to the Revised Atlanta Classification (2012). Receiver operating characteristic (ROC) analyses were performed to identify predictors of severe HTG-AP. Results: Mean maternal age was 29.8 ± 5.4 years and mean gestational age was 33.5 ± 3.3 weeks. A history of dyslipidemia was present in 26.8%, and gestational diabetes in 7.3%. In the severe group, triglyceride and lipase levels were highest (85.2 ± 41.6 mmol/L and 2310 ± 1942 U/L, respectively), while arterial pH was lower (7.2 ± 0.2) and the PaO₂/FiO₂ ratio decreased (252.5 ± 111 mmHg). Neonatal intensive care unit (NICU) admission occurred in 57.1% of newborns and neonatal respiratory distress in 28.6%. ROC analysis identified pH ≤ 7.31 (AUC = 0.929) and PaO₂/FiO₂ ≤ 258mmHg (AUC = 0.910) as the strongest prognostic markers for severe disease, each demonstrating sensitivity and specificity above 85%.