EXPERIENCE WITH EFFERENT METHODS USED IN THE TREATMENT OF SEVERE HYPERLIPIDEMIA IN A PREGNANT WOMAN

Objective. To evaluate the efficiency of using plasmapheresis (PA) and cascade plasma filtration (CPF) in a pregnant woman with severe hyperlipidemia. Subjects and methods. The paper describes a clinical observation of a female patient diagnosed as having 33—34-week pregnancy, chronic placental insufficiency, decompensated type 1 diabetes mellitus, diabetic micro- and macroangiopathy, hepatic steatosis, hyperlipidemia, and chronic pyelonephritis. She was treated with 3 PA sessions on a PSA-2 device (Haemonetics, USA) and 2 CPF sessions on a Cobe Spectra apparatus (Frezenius, Germany) with an Evaflux 5a filter (Kuraray, Japan). Clinical, biochemical, hemostasiological, and ultrasound studies were used. Results. There was a significant reduction in the lipid spectrum parameters: the levels of cholesterol, triglycerides, low-density lipoproteins, and thrombodynamic potential after a course of therapeutic PA and CPF. At 36 weeks gestation, the patient gave birth to a baby by cesarean section. The boy was alive, 47 cm in length, weighed 2359 g, with Apgar scores of 7/8. Conclusion. Efferent hemocorrection techniques should be considered as the methods of choice in treating pregnant women with obvious metabolic disturbances to prevent fatal pancreatitis and severe obstetric complications.

pregnancy, hyperlipidemia, hypertriglyceridemia, diabetes mellitus, plasmapheresis, cascade plasma filtration, neonatal infant