Preventive Management of Hypertriglyceridemia in Pregnancy: A Case Report

Abstract
Background: Hypertriglyceridemia in pregnancy is a rare but well-known cause of hypertriglyceridemia-induced acute pancreatitis (HTGP) in pregnancy, a life-threatening condition that lacks an established guideline for treatment management. Case presentation: We report a case with a successful treatment management of hypertriglyceridemia in pregnancy. A pregnant woman had been with hypertriglyceridemia for more than seven years and a history of pregnancy termination due to the development of HTGP. Eleven months after her last pregnancy termination, the woman was pregnant again and she started managing her elevated levels of lipids in the second trimester throughout the pregnancy, with low molecular weight heparin and then combined with metformin, to prevent thrombosis. Results: The entire pregnancy progressed smoothly, and the triglycerides' level fluctuated during the second and the third trimester of pregnancy with a range of 16.15 to 47.65 mmol/L. A full-term delivery, with a reasonable outcome for both mother and newborn, was obtained. Compared with her last pregnancy, the outcomes of recent pregnancy were better off. Conclusion: Low molecular weight heparin combined with metformin can avoid maternal hypertriglyceridemia-induced pancreatitis in this single case. To our knowledge, such a combination of treatment management of patients with hypertriglyceridemia in pregnancy to prevent acute pancreatitis has not been reported previously.