妊娠期严重高甘油三酯血症的产科治疗:病例报告。

IF 0.8 Q4 PEDIATRICS
AJP Reports Pub Date : 2024-10-11 eCollection Date: 2024-07-01 DOI:10.1055/a-2413-2465
Nigel Madden, Nevin Kamal, Jared Friedman, Priya Freaney, Susan E Gerber, Emily D Szmuilowicz
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引用次数: 0

摘要

背景 患有基线高甘油三酯血症的孕妇罹患严重高甘油三酯血症及相关并发症的风险增加,但目前还没有正式的建议来指导孕期对这些患者的管理。病例 我们报告了一例推测为家族性高甘油三酯血症的患者,她在孕前停用了降甘油三酯药物,并在妊娠 23 周时患上急性胰腺炎。她接受了极低脂饮食、运动、非诺贝特、ω-3 脂肪酸、普伐他汀、胰岛素输注和浆细胞疗法等治疗。她在妊娠 33 周时因 HELLP(溶血、肝酶水平升高和血小板低)综合征出现胎盘早剥和肝囊下血肿而分娩。结论 严重的高甘油三酯血症在妊娠期虽然罕见,但会给孕产妇带来严重的风险。孕前和产前产科管理应包括共同决策,既要考虑到治疗对胎儿的潜在风险,也要考虑到不治疗对产妇的客观风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Obstetrical Management of Severe Hypertriglyceridemia in Pregnancy: A Case Report.

Background  Pregnant people with baseline hypertriglyceridemia are at increased risk of severe hypertriglyceridemia and the associated complications, yet there are no formal recommendations to guide management of these patients during pregnancy. Case  We report a case of a patient with presumed familial hypertriglyceridemia who was taken off triglyceride-lowering medications preconception and developed acute pancreatitis at 23 weeks of gestation. She was managed with a very-low-fat diet, exercise, fenofibrate, omega-3-fatty acids, pravastatin, insulin infusion, and plasmapheresis. She delivered at 33 weeks of gestation after presenting with a placental abruption and subcapsular liver hematoma associated with HELLP (hemolysis, elevated liver enzyme levels, and low platelet) syndrome. Conclusion  While rare in pregnancy, severe hypertriglyceridemia is associated with serious maternal risks. Preconception and antepartum obstetric management should incorporate shared decision-making considering both the potential fetal risks of treatment and the objective maternal risks of untreated disease.

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来源期刊
AJP Reports
AJP Reports PEDIATRICS-
CiteScore
2.20
自引率
0.00%
发文量
30
审稿时长
12 weeks
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