Aggressive dietary modification, including a supervised fast and fat-free diet, successfully reduced severe gestational hypertriglyceridaemia from >50 mmol/L to 5.74 mmol/L by day 12 post partum.
Case Report (n=1)
No
Severe hypertriglyceridaemia in pregnancy can be successfully managed with aggressive dietary modification, including a supervised fast and fat-free diet.
A woman in her 30s with gestational diabetes presented at 36 weeks' gestation with reduced fetal movements and diminishing insulin requirements. In view of her gestation, she was induced and incidentally found to have profound hyponatraemia. Further biochemical investigations confirmed severe hypertriglyceridaemia and hypercholesterolaemia. This raises the possibility of secondary causes such as familial dysbetalipoproteinemia and polygenetic hypertriglyceridaemia. She was successfully managed by aggressive dietary modification. This involved a supervised fast followed by a fat-free diet. A fenofibrate was proposed but declined due to our patient's wish to breastfeed. Management required considerable input from the multidisciplinary team. Treatment options to consider are aggressive dietary restriction of fat or the addition of a cholesterol-lowering medication, such as a fibrate. In refractory cases, a supervised fast may be required or, in cases where complications have arisen, apheresis. The patient and her baby made a good recovery with no long-lasting health implications.
Barclay et al. (Mon,) conducted a case report in Severe gestational hypertriglyceridaemia (n=1). Aggressive dietary modification (supervised fast and fat-free diet) was evaluated on Serum triglyceride levels. Aggressive dietary modification, including a supervised fast and fat-free diet, successfully reduced severe gestational hypertriglyceridaemia from >50 mmol/L to 5.74 mmol/L by day 12 post partum.