Hyperlipidaemia and severe hypertriglyceridaemia in pregnancy

AbstractKey content Lipid and triglyceride levels increase in pregnancy and do not pose problems for most women. However, pregnancy-specific factors and genetic aberrations, especially mutations, may result in supraphysiological hypercholesterolaemia (HC) and severe hypertriglyceridaemia (sHTG). Hypercholesterolaemia and severe hypertriglyceridaemia are associated with complications in pregnancy, including acute pancreatitis, hyperviscosity syndrome and pre-eclampsia. Abnormally high levels of lipids and triglycerides also affect fetal growth and the onset of gestational diabetes. The clinical presentation and diagnosis of HC and sHTG are varied. Management options include lifestyle and dietary restriction/modification, omega-3, bile-acid sequestrants, fenofibrate, statins and plasmapheresis.Learning objectives To understand the physiological changes that occur in lipids in pregnancy and how these are modulated. To appreciate the importance of severe hypercholesterolaemia and hypertriglyceridaemia in pregnancy, including their effects on maternal morbidity and mortality. To understand the various approaches to management and the importance of multidisciplinary management.Ethical issues Should every woman be screened for HTG and hypercholesterolaemia during pregnancy? How safe are statins and other treatments for lipid disorders in pregnancy? Should women with very severe HTG be discouraged from getting pregnant?
Source: The Obstetrician and Gynaecologist - Category: OBGYN Authors: Tags: Review Source Type: research