Percutaneous endoscopic gastrostomy for nutrition support in pregnancy associated with hyperemesis gravidarum and anorexia nervosa.

BACKGROUND

Pregnant women with hyperemesis gravidarum (HEG) or anorexia nervosa are at high risk of developing malnutrition and adverse fetal outcome. Providing adequate nutrition support is the mainstay of therapy in these patients. Because of potential complications associated with total parenteral nutrition (TPN), enteral nutrition support is the preferred route.

METHODS

We describe the first two reported cases of percutaneous endoscopic gastrostomy (PEG) placement in two conscious pregnant women who could not tolerate oral feedings because of severe anorexia nervosa and HEG, respectively.

RESULTS

PEG was placed safely and provided adequate enteral nutrition in both patients, resulting in favorable maternal and fetal outcomes.

CONCLUSIONS

Our observation is the first demonstration that PEG may be a safe and effective alternative to TPN in selected pregnant women with HEG or anorexia nervosa who have failed conventional treatment.