Severe Hypertriglyceridemia in Pregnancy: Clinical Approach and Management Strategies

Severe hypertriglyceridemia (HTG) during pregnancy is a rare but serious condition associated with an increased risk of maternal and fetal complications. We report the case of a 36-year-old woman diagnosed with severe HTG at 28 weeks of gestation, with triglyceride (TG) levels of 2184 mg/dL (SI: 24.68 mmol/L) (reference range, 26.50-150 mg/dL [SI: 0.30-1.69 mmol/L]). Despite dietary intervention and ω-3 supplementation, levels continued to rise, requiring hospitalization and treatment with intravenous insulin. Due to refractory HTG, plasmapheresis was initiated at 33 weeks, with significant lipid reduction. At 34 weeks, the patient underwent an emergency cesarean delivery due to preterm labor. This case underscores the challenges of managing severe HTG in pregnancy and highlights the importance of early, multidisciplinary intervention. Further research is needed to refine treatment strategies and establish standardized guidelines for this high-risk population.