Unexpected fetal demise despite the reactive nonstress test during the conservative management of acute pancreatitis in pregnancy

INTRODUCTION: Dealing with acute pancreatitis in pregnancy is a challenging problem due to unexpected nature of the disease. PRESENTATION OF CASE: We report a complicated case of a 29-year-old pregnant woman with a mild acute pancreatitis whose pregnancy ended up with an unexpected fetal demise at her 34th gestational week. This unfortunate outcome led us reconsider our obstetrical approach to acute pancreatitis during pregnancy. CONCLUSION: Based on this unfortunate event, we now think that obstetricians should keep in mind that even in the presence of reassuring NST and biophysical profile assessment, an unpredictable fetal loss can occur during the medical management of the pregnancies complicated with mild acute pancreatitis. DISCUSSION: The subject patient of this case report was diagnosed with mild AP and underwent conservative medical management. Since the patient was stable and fetal well-being was confirmed with BPP and NST, the termination of pregnancy was out of question at that time. The occurrence of unexpected fetal death despite assuring parameters led us reconsider the approach to the pregnant women with mild AP.