Pregnancy outcome in patients requiring parenteral nutrition.
OBJECTIVE
The purpose of this retrospective study was to evaluate maternal and perinatal outcomes and complications of parenteral nutrition during pregnancy in our institution.


METHODS
This study was a review of medical records of all women who required parenteral nutrition during pregnancy at our institution from 1990-1997. The frequency of maternal and perinatal complications was calculated.


RESULTS
Twenty-six pregnancies required parenteral nutrition for the following indications: hyperemesis gravidarum (n = 16), cholecystitis/pancreatitis (n = 3), small bowel obstruction (n = 2), intracranial bleed (n = 2), ulcerative colitis (n = 1), and other (n = 2). The mean gestational age at initiation of therapy was 16.2 weeks and the mean duration of therapy was 30.6 days. Five pregnancies were terminated prior to fetal viability. Of the remaining pregnancies, obstetric complications occurred in 11, including two cases of idiopathic preterm labor resulting in preterm deliveries. Maternal complications resulting from the central venous catheters included four infections, two thromboses, one occlusion, one pneumothorax, and one catheter dislodgment. The complication rate for centrally inserted central catheters (50%) was significantly greater than the rate for peripherally inserted central catheters (9%).


CONCLUSIONS
Successful outcomes can be achieved in obstetric patients requiring parenteral nutrition. In this group of patients, the frequency of maternal complications secondary to centrally inserted central venous catheters was greater than that reported in nonpregnant patients. Peripherally inserted central catheters may be preferable when parenteral nutrition is required during pregnancy.
Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
K E
KE
Russo-Stieglitz
A B
AB
Levine
B A
BA
Wagner
V T
VT
Armenti
D000328:Adult; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002543:Cerebral Hemorrhage / Q000150:complications / Q000628:therapy; D002764:Cholecystitis / Q000150:complications / Q000628:therapy; D003093:Colitis, Ulcerative / Q000150:complications / Q000628:therapy; D005260:Female; D005865:Gestational Age; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000150:complications / Q000628:therapy; D007415:Intestinal Obstruction / Q000150:complications / Q000628:therapy; D010195:Pancreatitis / Q000150:complications / Q000628:therapy; D010288:Parenteral Nutrition; D011247:Pregnancy; D011248:Pregnancy Complications; D011251:Pregnancy Complications, Infectious / Q000209:etiology; D011256:Pregnancy Outcome; D012189:Retrospective Studies