The Freiburg Preeclampsia H.E.L.P.-Apheresis Study: rationale for lipid-apheresis in preeclampsia

Objective: During pregnancy the maternal lipid metabolism changes to meet the needs of the growing fetus, leading to an atherogenic profile. In pregnancies complicated by preeclampsia (PE) an even more atherogenic profile can be observed. H.E.L.P.-apheresis is an established method for lipoprotein removal and regeneration of endothelial function in severe hyperlipidemia. Besides lipids, 'pleiotropic effects' of H.E.L.P.-apheresis may involve the removal of inflammatory and thrombotic substances e.g. fibrinogen, IL-6, TNF-α, CRP and improvement of blood viscosity. Therefore, H.E.L.P.-apheresis is also applied when improvement of microcirculation is beneficial, e.g. in acute hearing loss or diabetic foot. Wang et al. (2006) successfully used the H.E.L.P.-technique in a first pilot study to prolong preeclamptic pregnancies by apheresis. We aimed to investigate the alterations in the lipid profile and the effects of H.E.L.P.-apheresis in the prolongation of pregnancies complicated by PE.