Mother back to her newborn after battling covid, jaundice and pancreatitis

Dr. Prerna Pallavi (Consultant Gastroenterologist - Ruby General Hospital)

33 years old lady, presented to her treating specialist after she suddenly developed pain abdomen and jaundice in last trimester of pregnancy. After initial evaluation she was diagnosed to have jaundice with gall stone disease and hence was taken up emergency caesarean section (outside). However post-surgery she continued to have jaundice with worsening pain abdomen and hence presented to us for further management. 

At presentation she was conscious oriented, had SIRS, mild respiratory distress and abdominal distention. Her covid status was positive with mild disease on HRCT, mixed pattern of jaundice, leukocytosis, b/l pleural effusion with necrotizing pancreatitis and evidence of gall stone disease with no biliary obstruction. 

She was started on standard management protocol for covid and pancreatitis along with other supportive treatment. With a good nursing and physiotherapy care she showed a gradual and complete recovery within 02 weeks, was pain free, tolerating orally and was discharged with a diagnosis of Acute nectrosing pancreatitis (moderately severe) – gall stone disease related, post LUCS, covid positive illness. She has been doing well now, planned for interval cholecystectomy and is happy to be back to her newborn. 

Jaundice in pregnancy is relatively rare but may have serious consequences on maternal and fetal health. Symptomaticgallstone disease is the second most common abdominal emergency in pregnant women affecting 6%, jaundice is seen in only about 1 in 20. Pancreatitis in pregnancy in the past had been associated with high maternal and fetal mortality. The recent advances in clinical gastroenterology have improved the early diagnosis and effective management of biliary pancreatitis