The Safety and Efficacy of Gastric Electrical Stimulation During Pregnancy in Patients With Medically Refractory Gastroparesis: Observations From a Multicenter Case Series.

OBJECTIVE

This study aimed to determine the safety and efficacy of gastric electrical stimulation (GES) in pregnant patients with medically refractory gastroparesis (GP).

MATERIALS AND

METHODS

Prospectively collected data from female patients with medically refractory GP who underwent implantation of a neurostimulator for GES within National Health Service Greater Glasgow and Clyde, between March 2009 and January 2024, were retrospectively analyzed. The primary outcomes of interest were the number of admissions to hospital with nausea and vomiting (N&V) across each trimester and the incidence of fetal and maternal complications during and after delivery.

RESULTS

Seven pregnancies were reported by six patients. The median age of patients during pregnancy was 27.5 years (26-29). Of these patients, 71% (n = 5) had diabetic GP. The median number of admissions to hospital with N&V during pregnancy was two (one-four), with the number of admissions to hospital reducing as the pregnancy progressed (nine admissions during first trimester vs six during the second vs one admission during the third). The median pregnancy term was 33 weeks (28-38), with 71% (n = 5) of pregnancies preterm. The mode of delivery was a cesarean birth in 86% of patients (n = 6), with two performed as emergencies. One patient had a postpartum hemorrhage, and another required admission to the intensive care unit because of renal failure after emergency cesarean birth. There were no maternal mortalities within 30 days of pregnancy. The median fetal birth weight was 1700 g (660-2930). One infant (14%) required admission to a level 3 neonatal intensive care unit owing to an underlying cardiac malformation and subsequently died six weeks after delivery.

CONCLUSION

The incidence of admission to hospital with N&V reduced with progression of the pregnancy in patients with medically refractory GP. Although all pregnancies ended in a live birth, the safety of GES therapy during pregnancy remains unclear and requires further study.