Archives of Gynecology and Obstetrics

, Volume 287, Issue 5, pp 839–843 | Cite as

Therapeutic apheresis for severe hypertriglyceridemia in pregnancy

  • Rafet Basar
  • Ayse Kubat UzumEmail author
  • Bulent Canbaz
  • Sema Ciftci Dogansen
  • Sevgi Kalayoglu-Besisik
  • Senem Altay-Dadin
  • Ferihan Aral
  • Nese Colak Ozbey
Maternal-Fetal Medicine



During pregnancy, a progressive increase in serum triglyceride (TG) and cholesterol levels is observed whereas TG levels mostly remain <300 mg/dl. In women with genetic forms of hypertriglyceridemia, pregnancy may cause extremely elevated TG levels leading to potentially life-threatening pancreatitis attacks and chylomicronemia syndrome. The only safe medical treatment option during pregnancy is ω-3 fatty acids, which have moderate TG lowering effects. Therapeutic apheresis could be used as primary treatment approach during pregnancy.

Materials and methods

We reported the effect of double filtration apheresis in one pregnant women with severe hypertriglyceridemia, therapeutic plasmapheresis and double filtration methods in the other severe hypertriglyceridemic pregnant woman; a 32-year-old pregnant woman (patient 1) with a history of hypertriglyceridemia-induced acute pancreatitis during pregnancy and a 30-year-old pregnant woman with extremely high TG levels (12,000 mg/dl) leading to chylomicronemia syndrome (patient 2). Medical nutrition therapy and ω-3 fatty acids were also provided. Double filtration apheresis (patient 1) and plasmapheresis + double filtration apheresis (patient 2) were used.

Result and conclusion

When we calculated the TG levels before and after therapeutic apheresis, maximum decrease achieved with double filtration apheresis was 46.3 % for patient 1 and 37.3 % for patient 2. However, with plasmapheresis TG level declined by 72 % in patient 2. Plasmapheresis seemed to be more efficient to decrease TG levels. Iron deficiency anemia was the main complication apart from technical difficulties by lipemic obstruction of tubing system. Healthy babies were born. Delivery led to decreases in TG levels. It is concluded that during pregnancy therapeutic apheresis is an effective method to decrease extremely high TG levels and risks of its potentially life-threatening complications.


Hypertriglyceridemia Pregnancy Acute pancreatitis Plasmapheresis Double filtration apheresis 


Conflict of interest

The authors certify that no actual or potential conflict of interest in relation to this article exists.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Rafet Basar
    • 1
  • Ayse Kubat Uzum
    • 2
    Email author
  • Bulent Canbaz
    • 2
  • Sema Ciftci Dogansen
    • 2
  • Sevgi Kalayoglu-Besisik
    • 3
  • Senem Altay-Dadin
    • 3
  • Ferihan Aral
    • 2
  • Nese Colak Ozbey
    • 2
  1. 1.Department of Internal MedicineIstanbul University, Istanbul Medical FacultyIstanbulTurkey
  2. 2.Division of Endocrinology, Department of Internal MedicineIstanbul University, Istanbul Medical FacultyIstanbulTurkey
  3. 3.Division of Hematology, Department of Internal MedicineIstanbul University, Istanbul Medical FacultyIstanbulTurkey

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