Total parenteral nutrition in pregnancy complicated by Crohn's disease

Despite the widespread use of total parenteral nutrition (TPN) in nonpregnant patients, the literature reflects limited experience with TPN in pregnancy. However, since maternal nutritional deprivation may cause adverse fetal effects, its use appears warranted. We present a case of a pregnant patient with a poor reproductive history and recently diagnosed Crohn's disease who required TPN. We discuss the use of TPN with fat emulsions in this patient who was unable to tolerate enteral feedings during pregnancy. The patient underwent a 4-week period without oral intake. Total parenteral nutrition enabled continued fetal growth, resulting in a good outcome for the patient and her infant. This report supports the early use of TPN in pregnancy complicated by inadequate caloric intake.