Enteral nutrition in hyperemesis gravidarum: a new development

Hyperemesis gravidarum occurs in up to 2% of pregnancies. Hospitalization is commonly required to treat dehydration and electrolyte and metabolic imbalances. Severe forms of hyperemesis gravidarum involving weight loss greater than 5% of prepregnancy weight have been associated with poor fetal growth and outcome. Hyperemesis gravidarum is a high-risk condition from a nutritional perspective. Traditional approaches to nutrition management focus on the cautious introduction of fluids and low-fat solids following resolution of acute nausea and vomiting. When trials of oral feeding fail to be tolerated, consideration should be given to the enteral route as the means of nutritional rehabilitation. A carefully designed delivery regimen combined with antiemetic therapy can prevent abdominal or sensory episodes that might precipitate further vomiting. Two case studies of the successful use of enteral nutrition in hyperemesis gravidarum are presented. Although clinical experience is limited and further research is needed, early results suggest that enteral nutrition in hyperemesis gravidarum is an effective and safe technique.