Total Parenteral Nutrition With Fat Emulsions During Pregnancy— Nutritional Requirements: A Case Report

Abstract

After a corrosive burn of the upper gastrointestinal tract leading to a severe dysphagia and to a weight loss of 15 kilograms, a 21-year-old female was treated by total parenteral nutrition (TPN) during the last 7 weeks of pregnancy. TPN by complete nutritive mixtures comprised daily crystalline amino acid solutions and as energy sources glucose plus lipids, the latter representing 43% of the nonprotein calories. A term normal 2800 gram female was delivered by cesarian section. This case report demonstrates the absence of any side effects on pregnancy related to fat emulsions used in usual proportions. Among the nutritional parameters studied here, the variations of weight and creatinine height index seem to be the best indicators of the maternal nutritional status in these cases. Approximately 50 kilocalories and 220 milligrams of nitrogen per kilograms body weight daily seem to be sufficient to restore and to maintain the maternal nutritional conditions and fetal growth.

Total Parenteral Nutrition During Pregnancy in a Patient Requiring Long‐Term Nutrition Support

“…Although concerns about prostaglandin synthesis as a result ofparenterallipid infusions have been raised, 11 parenteral lipid infusions have been used without complications for providing essential fatty acids and as an additional source of energy. 2 Few reports describe the use ofTPN from conception through pregnancy. 12 We report our experience in managing a young woman who has been on TPN since age 8 years, who conceived and bore a healthy infant, and who continues to receive parenteral nutrition support.…”

Outcomes Research, Nutrition Care, and the Provider—Payer Relationship

“…2 Few reports describe the use of TPN from conception through pregnancy. '-'O Most of these situations represent short intervals of nutrition support.…”

Successful Pregnancy Outcome using Total Parenteral Nutrition from the First Trimester of Pregnancy

“…( Journal of Parenteral and Enteral Nutrition 10: 665-669; 1986) Parenteral hyperalimentation has been used to supplement nutrient supply to the pregnant patient unable to maintain adequate nutrition as a result of underlying bowel disease or hyperemesis.I-2 Supplemental parenteral nutrition has permitted maintenance of normal fetal growth and development, when instituted in the second or third trimester. [3][4][5][6][7][8] Only three cases have been reported in which normal fetal growth and development resulted when parenteral nutrition was used as the primary source of nutrition throughout pregnancy 2,9, 10 but little is known of the effect of parenteral nutrition on maternal physiology and fetal development. In the first and third cases2, 10 caloric and nitrogen needs were assessed on clinical criteria alone.…”