[Hyperlipidemia and pregnancy].

Med Pregl

Klinicki centar Kragujevac, Centar za endokrinologiju, dijabetes i bolesti metabolizma, 34000 Kragujevac, Zmaj Jovina 30-33.

Published: October 2009

During pregnancy of healthy women, it is usual for blood lipids to increase significantly. Total cholesterol, HDL- and LDL-cholesterol increase 25-50%, while triglycerides increase twice to four times, and there is also an increase ofapolipoproteins B. However, this lipid expansion in blood does not lead to endothelial disfunction. Clinical problem are therapy dilemas about the women who were treated with antihyperlipemics during preconception period, possibility of diagnosing hyperlipidemia in pregnancy and their treatment during the pregnancy, then lactacy. It is generally accepted that neither of antihyperlipemic groups is completely harmless to be applied in preconception period, pregnancy and lactacy period. Those patients who had low to medium increased values of triglycerides prior to pregnancy may develop severe hypertriglyceridemia, especially in the third trimester. They must be educared about dietetic measures and body mass reduction even in preconcepticon period, while during pregnancy they must be supervised and in case of triglycerides increase above 11.5 mmol/l and the resulting risk of pancreatitis, other therapy options must be taken into consideration. In women who had hypercholesterolemia before pregnancy as well as those who developed it only during pregnancy, there is a risk of atherosclerosis development in fetus at the birth itself. Besides, children born by mothers with hypercholesterolemia have a risk of faster progression of these fatty streak during the first living year. Although statins do not represent major teratogenic substances in human pathology, it is advised to stop their application either before conception in planned pregnancy, or at the very moment when pregnany is confirmed (abortions are not encouraged).

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