Hiperkolesterolemia dalam Kehamilan

Oleh :

dr.Shandy Suwanto Putra,SpOG

Wanita hamil berisiko mengalami hiperkolesterolemia. Kehamilan pada wanita sehat dapat menyebabkan peningkatan fisiologis semua fraksi lipid dan lipoprotein. Hal ini disebabkan karena perubahan kadar estrogen, progesteron, insulin, dan laktogen plasenta manusia. Kolesterol merupakan komponen utama membran sel, prekursor hormon, seperti progesteron, dan sangat dibutuhkan pada perkembangan sistem neurologis. Kolesterol yang dibutuhkan janin didapatkan melalui sintesis endogen dan dari lipoprotein maternal yang ditranspor melewati plasenta.[1,2]

Peningkatan terbesar terlihat pada trigliserida (TG), yang meningkat 2–3 kali lipat, karena sintesis very low-density lipoprotein cholesterol (VLDL-C) di hepar. Kadar kolesterol total dapat meningkat hingga 60%. Peningkatan kolesterol high-density lipoprotein (HDL-C) tertinggi terjadi pada pertengahan kehamilan, yaitu sekitar 45%, dan menurun setelahnya. Low-density lipoprotein cholesterol (LDL-C) dapat meningkat hingga 45–50%, dan akan menetap selama masa nifas.[1,2]

Kehamilan merupakan keadaan stress pada tubuh wanita yang disertai dengan lingkungan proatherogenic, termasuk kelainan lipid, seperti hiperkolesterolemia dan hipertrigliseridemia. Kelainan lipid yang timbul dapat meningkatkan risiko atherosclerosis cardiovascular disease (ASCVD) dan luaran kehamilan yang kurang baik bagi ibu maupun janin.[1,3,4]

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Referensi

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