Prolongation of Pregnancy in Preeclampsia by Therapeutic Lipid Apheresis

Conditions

Dyslipidemia, Hypertension, Preeclampsia, Proteinuria

Keywords

preeclampsia, lipid apheresis, apheresis

Brief summary

Preeclampsia is a disease which occurs in about 6-8% of all pregnancies and is the main cause of maternal and fetal morbidity and mortality. The cause of preeclampsia is still not clear and the only therapy is preterm caesarean section. In severe preeclampsia an accumulation of triglyceride-rich lipoproteins occurs. Therefore, lipid apheresis is performed as lipid-removing therapy for treatment of preeclampsia in order to prolong pregnancy and provide the fetus more time for maturation. In this individual treatment patients with early preeclampsia (\<= 32 weeks of gestation) will be offered a H.E.L.P.-apheresis to postpone caesarean section and therefore prolong pregnancy.

Karl Winkler, Cornelia Lorey, Christine Contini, Vivian Augustinski, Gerhard Pütz et al. (11 authors)

Pregnancy Hypertension2024-05-094 citations

10.1016/j.preghy.2024.101128

Treatment of very preterm preeclampsia via heparin-mediated extracorporeal LDL-precipitation (H.E.L.P.) apheresis: The Freiburg preeclampsia H.E.L.P.-Apheresis study.

Winkler K, Contini C, König B, Krumrey B, Pütz G, Zschiedrich S, Pecks U, Stavropoulou D, Prömpeler H, Kunze M, Markfeld-Erol F.

2018-04-1117 citations

10.1016/j.preghy.2018.04.007

Lipoprotein turnover and possible remnant accumulation in preeclampsia: insights from the Freiburg Preeclampsia H.E.L.P.-apheresis study.

Contini C, Jansen M, König B, Markfeld-Erol F, Kunze M, Zschiedrich S, Massing U, Merfort I, Prömpeler H, Pecks U, Winkler K, Pütz G.

2018-03-1412 citations

10.1186/s12944-018-0698-4

Interventions

OTHERlipid apheresis

Study design

Allocation

NA

Intervention model

SINGLE_GROUP

Primary purpose

TREATMENT

Masking

NONE

Eligibility

Sex/Gender

FEMALE

Age

18 Years to No maximum

Healthy volunteers

No

Inclusion criteria

* pregnant women * early preeclampsia (\< 32 week of pregnancy) * arterial hypertension during pregnancy * proteinuria (=\> 1 + dipstick or 0\> 300 mg/24h) * and/or intrauterine growth retardation (IUGR) * informed consent

Exclusion criteria

* every acute indication for immediate delivery * no informed consent

Design outcomes

Primary

Measure	Time frame	Description
Prolongation of pregnancy	Mother will be followed up for the duration of hospital stay, that is from first lipid apheresis until the discharge of the mother in the days following birth (an expected average of 3-4 weeks).	A deteriorating clinical condition of the mother and the fetus necessitates a caesarean section (c.s.). However, if c.s. takes place too early lung maturation of the fetus may not be completed. Apheresis is initiated and will be continued until lung maturity is achieved and the clinical condition of the mother and the fetus improves.

Secondary

Measure	Time frame
Reduction of lipoprotein levels	Mother will be followed up for the duration of hospital stay, that is from first lipid apheresis until the discharge of the mother in the days following birth (an expected average of 3-4 weeks).

Other

Measure	Time frame
Normalization of blood pressure measured in mmHg.	Mother will be followed up for the duration of hospital stay, that is from first lipid apheresis until the discharge of the mother in the days following birth (an expected average of 3-4 weeks).
Normalization of proteinuria measured in 24-h urine collection in mg/dl	Mother will be followed up for the duration of hospital stay, that is from first lipid apheresis until the discharge of the mother in the days following birth (an expected average of 3-4 weeks).

Countries

Germany

Outcome results

None listed