Total Parenteral Nutrition Treatment in a Diabetic Pregnant Woman Complicated with Hyperemesis Gravidarum, Malnutrition, and Intrauterine Growth Restriction

Abstract

We report a case of a pregnant woman with diabetes, complicated with hyperemesis gravidarum, malnutrition, and intrauterine growth restriction, who was treated beneficially with total parenteral nutrition. A 26-year-old diabetic nullipara complained of severe nausea and vomiting from early in her pregnancy. Malnutrition developed at about 24 weeks of gestation. In spite of treatment with antiemetics, antihistamine, and vitamin B6, the symptoms persisted, and intrauterine growth restriction eventually developed. Total parenteral nutrition was commenced at 29 weeks of gestation. She delivered a healthy female neonate with a birth body weight of 2,120 g at 36 weeks of gestation by cesarean section. Total parenteral nutrition was gradually tapered off 1 week later, and the mother was discharged from hospital in good condition 10 days after delivery. Total parenteral nutrition may be used to treat diabetic patients with hyperemesis gravidarum who develop malnutrition causing intrauterine growth restriction.