Parenteral nutrition in obstetries and gynecology

Abstract

In gynaecology the problems of parenteral nutrition have become increasingly important, especially in view of the advanced methods of radical surgery and the intensification of radiotherapy. Furthermore, more older patients in a poor state of health also undergo major surgery. In many of these patients food cannot be given by the oral route or can ~nly be given inadequately. If this situation continues for any significant period, parenteral nutrition will be necessary. In gynaecology, long-term complete parenteral nutrition is seldom necessary; short-term complete parenteral nutrition, however, is required more often. Especially in ultraradical surgical procedures, an adequate metabolic control -and this means in many cases parenteral nutrition -is certainly necessary and decisive for therapeutic success.In the Department of Obstetrics and Gynaecology at the University of Frankfurt/Main, about 4.500 women receive clinical treatment every year. On the average, about 150 to 200 of these women receive parenteral nutrition for short or long periods. INDICATIONSComplete parenteral nutrition becomes necessary in almost every case of radical and ultraradical surgery in gynaecology. After ultraradical operations and frequently also second-look operations, short-term or long-term parenteral nutrition is one of the most essential conditions for any success. After radical operations for cancer of the cervix uteri, we generally give short-term parenteral nutrition for four or five days. If, however, complications such as infections, ileus or renal failure occur, complete parenteral nutritioh becomes necessary for a longer period. Further indications for total parenteral nutrition in gynaecology are cancerous cachexia, patients undergoing chemotherapy and anorexia nervosa.In obstetrics, parenteral nutrition is seldom indicated. It becomes necessary in cases of severe eclampsia with acute renal failure, in cases of septic

Esophageal Achalasia: An Uncommon Complication during Pregnancy Treated Conservatively

“…Recent data suggest that increased preterm delivery rates observed in the past were a reflection of the underlying maternal condition, rather than direct consequence of the lipid component formulations for TPN [16]. Despite the risk of infection and thrombosis, maternal and neonatal outcome are not compromised by the use of TPN [19, 20]. Russo-Steiglitz et al [18] had studied the nutritional status and maternal/neonatal outcome in ten patients with severe hyperemesis treated with TPN.…”

Nutritional management of pregnancy in patients on home parenteral nutrition

“…Although the use of lipid emulsions in pregnant animals has been associated with premature labour (Heller 1977), there has not, so far. One of our patients went into premature labour at 30 weeks gestation.…”

“…One of our patients went into premature labour at 30 weeks gestation. Although the use of lipid emulsions in pregnant animals has been associated with premature labour (Heller 1977), there has not, so far. been any evidence that the same occurs in man.…”