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MS WordPerinatologist Corner - C.E.U/C.M.E. Modules
Preconception Counseling for Women with Diabetes and Hypertension
Sponsored by The Indian Health Service Clinical Support Center
Step 9. Hypertriglyceridemia
Hyperlipidemia is one of the most striking modification of biological parameters occurring during normal pregnancy. Hypertriglyceridemia is the most prominent feature, with a less dramatic increase of total cholesterol levels. Besides these quantitative changes, most lipoproteins undergo qualitative modification throughout pregnancy such as triglyceride enrichment of the particles. Except from exceptional complications, dietary counselling will be the only treatment, under a close follow-up
An occasional patient with familial hypertriglyceridemia may be at risk of life-threatening pancreatitis during pregnancy. Triglycerides are usually in the thousands in affected women. In this rare situation, treatment with gemfibrozil is indicated. In general, dietary counseling is usually all that is necessary for most women during pregnancy. Gemfibrozil is pregnancy class C.
Because the long-term treatment of the maternal hyperlipidemia is not significantly impaired by discontinuing these medications during pregnancy and lactation, and the current recommendations not to use them during pregnancy, it seems reasonable to discontinue them when pregnancy is diagnosed, and not start them if pregnancy is planned.
