Successful hyperlipemic pregnancy.
Abstract
Women with hypertriglyceridemia are prone to gestational pancreatitis, a condition carrying substantial maternal and fetal risk. We describe a 33-year-old woman with familial hypertriglyceridemia who had recurrent hyperlipidemic abdominal crises during previous pregnancies despite dietary fat restrictions. A fifth pregnancy was carried to term without complications after aggressive dietary therapy and intermittent intravenous feeding, administered whenever her triglyceride levels exceeded an arbitrarily selected threshold concentration of 28 mmol/L. The efficacy of this approach may be explained by the published observation that low-fat (high-carbohydrate) isocaloric diets elevate serum triglyceride levels by the oral, but not the intravenous, route in normal individuals. Reduction of this patient's serum triglyceride concentrations by interrupting oral intake and administering intravenous glucose appeared to prevent late-pregnancy pancreatitis and culminated in uncomplicated full-term delivery.
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In women with underlying disorders of triglyceride metabolism or overproduction, an estrogen-induced increase in triglycerides during pregnancy can result in risk of pancreatitis with potential fetal loss.
“In women with underlying disorders of triglyceride metabolism or overproduction, an estrogeninduced increase in triglycerides during pregnancy can result in a risk of pancreatitis with potential fetal loss (85, 86).”
From Evaluation and Treatment of Hypertriglyceridemia: An Endocrine Society Clinical Practice Guideline (2012) · cites this paper as [85]
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- Authors
- Sanderson, S. L.
- Affiliations
- Veterans Health Administration (US)
- Corresponding author
- Sanderson, Susan L.
- Venue
- JAMA: The Journal of the American Medical Association
- Publisher
- American Medical Association (AMA)
- Published
- 1991-04-10
- Volume
- 265
- Issue
- 14
- Pages
- 1858
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2130171318
- Cited by
- 57
- References
- 20
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 1 · 2018: 4 · 2015: 1 · 2014: 1 · 2012: 4
- FWCI
- 2.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Research Resources (RR 00064)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Keywords
- hypertriglyceridemia, familial hypertriglyceridemia, dietary fat restriction, parenteral nutrition, intravenous glucose, oral glucose, serum triglycerides, isocaloric diet, full-term delivery
- MeSH terms
- Adult, Female, Humans, Infant, Newborn, Male, Pancreatitis, Pregnancy, Pregnancy Complications, Hypertriglyceridemia
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