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Hyperemesis Gravidarum: Outcomes and Complications With and Without Total Parenteral Nutrition
Author(s) -
Folk JJ,
LeslieBrown HF,
Nosovitch JT,
Silverman RK,
Aubry RH
Publication year - 2005
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0115426505020003364
Subject(s) - medicine , hyperemesis gravidarum , pregnancy , parenteral nutrition , incidence (geometry) , thyroid function , obstetrics , medical record , gestational age , pediatrics , abortion , vomiting , surgery , thyroid , genetics , physics , optics , biology
Objective: To evaluate the obstetric and medical complications with hyperemesis gravidarum, comparing those who were supported with total parenteral nutrition (TPN group) and those who did not receive TPN (non–TPN group). Study Design: The medical records of women with a diagnosis of hyperemesis gravidarum ( ICD‐9 code 643) admitted to Crouse Hospital, Syracuse, New York, between January 1995 and December 1998 were reviewed. A total of 166 subjects were identified and 192 admissions reviewed. Information was gathered for age, gestational age, gravity and parity, marital status, length of stay, and number of admissions, and a review of electrolyte, albumin, and thyroid function was performed. An assessment of pregnancy complications and outcomes was undertaken. Results: Of the cases reviewed, 16% (27/166) were treated with PN. The 2 groups were similar regarding incidence of pregnancy‐related and maternal medical complications. The groups were similar when comparing objective measures, such as serum potassium, bicarbonate, albumin, and thyroid function. The PN group had a significantly increased incidence of complications directly attributed to parenteral therapy. Among multiparous patients in both groups, 69% had a prior pregnancy that had ended in spontaneous or induced abortion. Conclusion: The PN group had a marked and significant increase in serious complications directly related to PN use. These data suggest that great care should be taken to assess the need for parenteral therapy in patients with hyperemesis gravidarum. A history of loss in the antecedent pregnancy may be a risk factor for a subsequent pregnancy complicated by hyperemesis gravidarum.