Peripheral parenteral nutrition in protracted hyperemesis gravidarum - Report of two cases and a literature review

Hyperemesis gravidarum is defined as severe nausea and vomit- ing during the first trimester of pregnancy. It is characterized by dehydration, electrolyte imbalance, ketonuria and weight loss of more than 5% of body weight and it usually requires hospitaliza- tion. Traditionally, total parenteral nutrition has been used when patients with hyperemesis gravidarum fail to respond to conserva- tive measures, including dietary manipulation and antiemetics. Total parenteral nutrition has been shown to be an effective method of nutritional support during pregnancy but it is expensive and has potentially serious complications. Peripheral parenteral nutrition reduces the risk of complications, but caloric intake is limited. A small number of investigators have suggested using enteral nutrition as an alternative to total parenteral nutrition. Herein we report two cases of hyperemesis gravidarum successful- ly treated with an effective regimen of peripheral parenteral nutri- tion. (Acta gastroenterol. belg., 2008, 71, 259-262).