Conception, Pregnancy, and Lactation Despite Chronic Intestinal Failure Requiring Home Parenteral Nutrition

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
Bettina M BuchholzWaltraut M Merz

Abstract

Short-term parenteral nutrition is commonly accepted to be safe in pregnancy, but knowledge about the management of pregnancy during long-term home parenteral nutrition (HPN) is sparse. A systematic literature review revealed that the published experience is limited to 15 pregnancies with parenteral nutrition from preconception to delivery and beyond. Maternal morbidity was surprisingly low, and fetal outcome was good; however, micronutrient deficiencies may have contributed to fetal anomalies. Herein, we additionally report the case of a 26-year-old Caucasian woman with long-term HPN dependence secondary to short bowel syndrome caused by recurrent thromboembolic mesenteric infarctions who delivered a healthy fetus at 37 weeks of gestation. Individual macronutrient support and adequate micronutrient supplementation ensured normal maternal weight gain and fetal development. Based on the individual maternal risk of recurrent thrombosis, anticoagulant treatment was carefully titrated throughout pregnancy. Furthermore, loss of abdominal domain with a rigid maternal abdominal wall secondary to short bowel syndrome and multiple laparotomies resulted in food intolerance during the third trimester. Still, with multidisciplinary efforts...Continue Reading

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Citations

Sep 15, 2016·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Lore BilliauwsFrancisca Joly
Nov 11, 2016·Obstetric Medicine·Ailsa Borbolla FosterJohanna Trinder
Nov 26, 2016·BJOG : an International Journal of Obstetrics and Gynaecology·V BlackwellP J Allan

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Methods Mentioned

BETA
cesarean section

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