Use of Fenofibrate During the First Trimester of Unplanned Pregnancy in a Patient with Hypertriglyceridemia

Abstract

To describe a successful pregnancy in a patient who used fenofibrate during the first trimester. A 30-year-old female with a history of polycystic ovarian syndrome was referred to our department for evaluation of hypertriglyceridemia, and fenofibrate treatment was initiated. After 1 year of therapy, a gynecologic visit for menstrual cycle abnormalities revealed an unplanned pregnancy at 8 weeks of gestation (dating from the first day of the last menstrual period). Fenofibrate was discontinued and the pregnancy was continued despite the potential risks involved with the use of fibrates during early pregnancy. Fetal ultrasound performed routinely during each trimester showed normal fetal growth with no malformation. The patient delivered a healthy male infant at 36 weeks of gestation. No congenital malformation was recorded. The baby was healthy on pediatrician examination at 1 year. Fibrates have good efficacy in lowering fasting triglyceride (TG) levels as well as postprandial TG and TG-rich lipoprotein remnant particles. Previous reports showed that fibrates have been administered cautiously in pregnant women after embryogenesis if their use is necessary; however, in our case, the embryo had been exposed to fenofibrate from the beginning of fertilization. Nevertheless, fenofibrate did not cause significant damage, such as external, skeletal, and visceral abnormalities, to the developing embryo. In this case, no harmful effects on fetal development were observed after exposure to fenofibrate during organogenesis.