Severe hypertriglyceridemia in pregnancy. A clinical case report]

Cholesterol (TC) and triglyceride (TG) plasma levels physiologically increase during pregnancy. The lipid increment is respectively 23%-53% above pregravidic level for TC and two-three fold the pre-pregnancy level for TG. If the TC and TG are higher than normal values in pregnancy the patient must be carefully monitored. Acute pancreatitis is the main consequence of hyperlipidemia and it can occur either during pregnancy, in the third trimester, or in the puerperium. Mortality is high both for the mother (21%) and the fetus (20%). The authors report a case of 37-year-old pregnant woman at 35 week gestation with hypercholesterolemia (TC = 425 mg/dl) and severe hypertriglyceridemia (TG = 3315 mg/dl). The patient was admitted to the hospital for treatment with an appropriate diet and drug lowering lipid levels (gemfibrozil). The baby was delivered by cesarean section at week 36. The neonatal weight at birth was 2670 g and the Apgar score was 9 at the first minute. After delivery the maternal triglyceride levels showed a remarkable reduction. According to a review of the literature, severe hypertriglyceridemia in pregnancy should be treated with a careful restriction of calories and fat; for preventing acute pancreatitis hospitalization for intravenous fluid therapy and plasma exchange must be required.