Caruso A, De Carolis S, Ferrazzani S, Trivellini C, Mastromarino C, Pittiruti M
Department of Obstetrics and Gynecology, Catholic University, Rome, Italy.
Fetal Diagn Ther. 1998 May-Jun;13(3):136-40. doi: 10.1159/000020824.
We evaluated pregnancy outcome and fetal growth in women requiring total parenteral nutrition (TPN).
Eleven malnourished pregnant women were treated with TPN in a single institution, starting at a mean gestational age of 20+/-8 weeks (+/- SD). Serial ultrasound evaluations of fetal growth (biparietal diameter, femur length, abdominal circumference) were performed. The paired Student t test and Wilcoxon signed-rank test were used for the statistical analysis: p values <0.05 were considered significant.
The duration of TPN ranged from 14 to 220 days. Maternal nutritional state was well preserved and no complications were related to treatment. A gestational age of 35+/-3 weeks at delivery (mean +/- SD), birth weight of 2,251+/-670 g (mean +/- SD) and birth percentile of 29+/-16 (mean +/- SD) were observed. One intrauterine death occurred. The comparison between the sonographic findings, before and 2 weeks after starting TPN, showed a fetal percentile gain with a statistically significant increase in the abdominal circumference percentile (p < 0.05) from a median percentile of 2 (range 2-32) to 33 (range 2-78).
TPN proved to be helpful and lifesaving in malnourished pregnant women and promoted fetal growth, as shown by the longitudinal ultrasonographic evaluations.
我们评估了需要全胃肠外营养（TPN）的女性的妊娠结局和胎儿生长情况。
11名营养不良的孕妇在单一机构接受TPN治疗，开始治疗时的平均孕周为20±8周（±标准差）。对胎儿生长情况（双顶径、股骨长度、腹围）进行了系列超声评估。采用配对t检验和Wilcoxon符号秩检验进行统计分析：p值<0.05被认为具有统计学意义。
TPN治疗时间为14至220天。孕妇的营养状况得到良好维持，且无与治疗相关的并发症。观察到分娩时的孕周为35±3周（平均±标准差），出生体重为2251±670 g（平均±标准差），出生百分位数为29±16（平均±标准差）。发生了1例宫内死亡。开始TPN治疗前和治疗2周后的超声检查结果比较显示，胎儿百分位数增加，腹围百分位数从第2百分位数（范围2 - 32）中位数显著增加至第33百分位数（范围2 - 78）（p < 0.05）。
纵向超声评估显示，TPN被证明对营养不良的孕妇有益且可挽救生命，并能促进胎儿生长。
