Burke M E, Vangellow J
NAACOGS Clin Issu Perinat Womens Health Nurs. 1990;1(2):240-54.
Anorexia nervosa and bulimia nervosa primarily affect women who are in the childbearing years. While many anorectic patients are unable to ovulate second to the disruptions of normal body function associated with anorexia, there are still women who will ovulate and become pregnant. Bulimia nervosa may also disrupt the normal menstrual cycle if the disease is very severe. However, many bulimic patients will become pregnant. Both of these disease states cause a decrease in circulating plasma volume, fluid and electrolyte shifts, and other alterations that may increase the risk to a pregnancy and developing fetus. Severe disease states are associated with intrauterine fetal growth retardation (IUGR). The nursing care of the anorectic or bulimic patient who becomes pregnant is specialized and requires coordination between nursing, perinatology, and the psychiatric team, as well as support services including nutritionists. The nursing care of anorectic patients is difficult and requires an understanding of the complex psychological and physical pathophysiology of the disease. Bulimia nervosa also requires a complete understanding of the psychological and pathophysiology of the disease process. This article provides a review of the syndromes, risk factors, definitions of the disease states, and the nursing management of those patients experiencing a pregnancy complicated by the predisposing factors of anorexia nervosa, and/or bulimia nervosa.
神经性厌食症和神经性贪食症主要影响育龄女性。虽然许多厌食症患者由于与厌食症相关的正常身体功能紊乱而无法排卵，但仍有女性会排卵并怀孕。如果神经性贪食症病情非常严重，也可能扰乱正常月经周期。然而，许多贪食症患者会怀孕。这两种疾病状态都会导致循环血浆量减少、体液和电解质失衡以及其他改变，这些可能会增加怀孕和胎儿发育的风险。严重疾病状态与宫内胎儿生长受限（IUGR）有关。怀孕的厌食症或贪食症患者的护理是专门化的，需要护理、围产医学和精神科团队之间的协调，以及包括营养师在内的支持服务。厌食症患者的护理很困难，需要了解该疾病复杂的心理和生理病理生理学。神经性贪食症也需要全面了解疾病过程的心理和病理生理学。本文综述了这些综合征、危险因素、疾病状态的定义，以及患有因神经性厌食症和/或神经性贪食症的易感因素而并发妊娠的患者的护理管理。
