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Fetal Salvage with Maternal Total Parenteral Nutrition: The Pregnant Mother as Her Own Control
Author(s) -
Stellato Thomas A.,
Danziger Larry H.,
Burkons David
Publication year - 1988
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607188012004412
Subject(s) - hyperemesis gravidarum , medicine , parenteral nutrition , pregnancy , fetus , obstetrics , vomiting , enteral administration , intensive care medicine , surgery , biology , genetics
Hyperemesis gravidarum affects both maternal and fetal well‐being by reducing maternal vascular volume (normally increased with pregnancy) and depleting maternal nutritional stores. Severe intractable hyperemesis may result in fetal demise. This report documents the ability to maintain maternal fluid and nutritional requirements during first trimester pregnancy in a female with intractable hyperemesis gravidarum. Additionally, this patient is unique in that her five prior pregnancies were complicated by hyperemesis with the last three resulting in fetal demise. Speculation regarding the relative importance of inadequate hydration and nutrition in first trimester fetal viability is given. When hyperemesis is unresponsive to conventional management, intravenous hydration should be instituted without delay to preserve maternal intravascular blood volume and thus placental blood flow. Consideration for total parenteral nutrition can then be given which, after adequate in‐hospital instruction, may in most cases be continued in the home. (Journal of Parenteral and Enteral Nutrition 12 :412–413, 1988)