Pregnancy outcome and total parenteral nutrition in malnourished pregnant women.
OBJECTIVE
We evaluated pregnancy outcome and fetal growth in women requiring total parenteral nutrition (TPN).


METHODS
Eleven malnourished pregnant women were treated with TPN in a single institution, starting at a mean gestational age of 20+/-8 weeks (+/- SD). Serial ultrasound evaluations of fetal growth (biparietal diameter, femur length, abdominal circumference) were performed. The paired Student t test and Wilcoxon signed-rank test were used for the statistical analysis: p values <0.05 were considered significant.


RESULTS
The duration of TPN ranged from 14 to 220 days. Maternal nutritional state was well preserved and no complications were related to treatment. A gestational age of 35+/-3 weeks at delivery (mean +/- SD), birth weight of 2,251+/-670 g (mean +/- SD) and birth percentile of 29+/-16 (mean +/- SD) were observed. One intrauterine death occurred. The comparison between the sonographic findings, before and 2 weeks after starting TPN, showed a fetal percentile gain with a statistically significant increase in the abdominal circumference percentile (p < 0.05) from a median percentile of 2 (range 2-32) to 33 (range 2-78).


CONCLUSIONS
TPN proved to be helpful and lifesaving in malnourished pregnant women and promoted fetal growth, as shown by the longitudinal ultrasonographic evaluations.
Department of Obstetrics and Gynecology, Catholic University, Rome, Italy.
A
A
Caruso
S
S
De Carolis
S
S
Ferrazzani
C
C
Trivellini
C
C
Mastromarino
M
M
Pittiruti
D000328:Adult; D005314:Embryonic and Fetal Development; D005260:Female; D006801:Humans; D009748:Nutrition Disorders / Q000209:etiology / Q000628:therapy*; D010289:Parenteral Nutrition, Total; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000628:therapy*; D011256:Pregnancy Outcome; D012189:Retrospective Studies