Gestational Hypertriglyceridemia Management and the Utility of Multidisciplinary Care

BACKGROUND: Severe hypertriglyceridemia (HTG) in pregnancy can lead to adverse outcomes such as preeclampsia, preterm delivery, and pancreatitis. However, there are no official management guidelines for gestational HTG. CASE SUMMARY: A 33-year-old woman at 32 weeks of gestation presented to the lipid clinic for severe HTG. With a multidisciplinary care team, a treatment plan including fenofibrates and icosapent ethyl was initiated. The treatment plan successfully reduced triglycerides and led to an uncomplicated delivery. DISCUSSION: Gestational HTG can pose severe risks to pregnant patients. Limited safety data exist on treatment options in pregnant patients; thus there are no official management guidelines for treating this condition. Future work is needed to establish official guidelines for gestational HTG and preconception counseling to protect the mother and fetus. TAKE-HOME MESSAGE: Given the treatment barriers of HTG in this vulnerable population, we present a case where multidisciplinary care successfully managed severe HTG in pregnancy.