Parenteral nutrition in hyperemesis gravidarum

Hyperemesis gravidarum (HG) is a clinical condition that threatens fetal viability and even the mother's life when the severity of symptoms almost completely prevents the intake of food. Parenteral nutrition (PN) is a possible alternative. We present eight patients with HG. There were 10 PN treatments because two of the patients required the treatment twice. There were 9 central venous and 1 peripheral treatment delivery. The average age of the patients was 27.5 yr. Gestational ages varied from 8 to 19 wk. PN treatments were formulated as amino acid and glucose solutions (fat emulsions in 2 of the 8 cases) blended with vitamins and electrolytes. These treatments lasted 5-16 days. Before PN deliveries were initiated, five of the patients presented some degree of protein-calorie and/or visceral protein malnutrition. All of them showed minor liver dysfunction, which did not change during PN. Newborns were term deliveries, except for one case of missed abortion. Results show that PN constitutes a therapeutic alternative in cases of HG that do not respond to the standard treatment of parenteral hydration and antiemetics. In fact, symptoms disappear promptly, and no significant complications arise.