Table 2.

Management of severe hypercholesterolaemia during pregnancy

Non-pharmaceutical interventions	Pre-conception plan Diet, physical activity	In each pregnancy
Bile acid sequestrants	Approved during pregnancy May lead to hypertriglyceridaemia Poorly tolerated systemic side effects	In each pregnancy
Ezetimibe	When the benefits outweigh the risks	Individual decision
Fibrates	When the benefits outweigh the risks	Individual decision
Omega-3 fatty acids	When the benefits outweigh the risks Reduce triglycerides	Individual decision
Statins	Generally contraindicated For severe hypercholesterolaemia, the decision should be individualized	Individual decision in severe hypercholesterolaemia
PCSK9i	Limited data	Lacking data
Inclisiran	No data regarding pregnancy available Hypothetically, administration before pregnancy may give a mean 41% reduction of LDL-C	Lacking data, potentially useful in severe hypercholesterolaemia
Apheresis	The potential benefits and risks associated with the procedure should be considered Available in specialized centres In some cases, the only one available therapeutic option	In each pregnancy Limited availability