[Total parenteral nutrition in pregnancy].
The authors report three cases of pregnant women who were incapable or unable to freed themselves enterally and were monitored by the Division of Obstetrics and Gynecology at the "Burlo Garofolo" Institute for Infancy from 1992 to 1996. The series included two patients suffering from severe hyperemesis gravidarum and a third patient with severe atopic eczema secondary to food allergens. Starting at different stages of pregnancy these patients were treated using total parenteral nutrition (TPN) following the placement of a venous catheter using percutaneous access through the subclavian artery and leading into the superior vena cava. This solution not only ensured an appropriate calorie intake but also enabled electrolytic controls to be performed, adapting the intake of these elements to the real needs of the patients assessed by means of regular hematochemical tests. It is also worth pointing out that the calorie intake supplied during TPN was achieved through the use of lipid emulsions whose administration during pregnancy has been regarded as being risky owing to the possible onset of fatty placental infiltrations and the enhanced risk of premature birth. The authors underline the good results obtained in this series using TPN both with regard to the satisfactory level of maternal nutrition and the optimal evolution of pregnancy leading to the birth of healthy neonates with a normal weight.
Instituto per l'Infanzia Burlo Garofolo-Trieste, Divisione di Ostetricia e Ginecologia.
G
G
Maccarrone
D
D
Faraguna
M
M
Candusso
A
A
Monterosso
D000328:Adult; D003876:Dermatitis, Atopic / Q000150:complications*; D005260:Female; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000150:complications*; D010289:Parenteral Nutrition, Total; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011264:Pregnancy Trimesters