ArticleJPEN. Journal of parenteral and enteral nutrition
Feeding jejunostomy for the treatment of severe hyperemesis gravidarum: a case series.
Article in JPEN. Journal of parenteral and enteral nutrition. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Interventions for treating hyperemesis gravidarum.The Cochrane database of systematic reviews · 2016Pooled it
- Safety of Percutaneous Endoscopic Gastrostomy Placement in Pregnancy: A Case Report and Literature Review.Case reports in gastrointestinal medicine · 2022Article
- Over-the-scope-clip system secured nasojejunal tube feeding in refractory hyperemesis gravidarum.BMJ case reports · 2017Article
- Vitamin K Deficiency Embryopathy from Hyperemesis Gravidarum.Case reports in obstetrics and gynecology · 2015Article
- Use of Gastrostomy Tube to Prevent Maternal PKU Syndrome.JIMD reports · 2012Article
- Risks versus benefits of gastrointestinal endoscopy during pregnancy.Nature reviews. Gastroenterology & hepatology · 2011Review
- Nausea and vomiting of pregnancy.Gastroenterology clinics of North America · 2011Review
- Percutaneous Endoscopic Jejunostomy Tube Placement for Treatment of Severe Hyperemesis Gravidarum in Pregnancy.Journal of investigative medicine high impact case reportsArticle
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundHyperemesis gravidarum is severe nausea and vomiting during pregnancy leading to dehydration, nutrition deficiency, and fetal morbidity and mortality. Treatment must maintain fluid and electrolyte balance and caloric intake. Parenteral nutrition is often attempted; however, complication rates are high. Nutrition via nasoenteric and percutaneous endoscopic gastrostomy tubes is limited by poor patient tolerance, tube dislodgement, and altered anatomy in pregnancy.
methodsWomen with hyperemesis gravidarum who failed standard therapy were offered jejunostomy. All patients underwent surgical jejunostomy in the second trimester. Isotonic tube feeds were administered to a goal caloric factor calculated by the Harris-Benedict equation with a correction added for pregnancy. Patients were monitored until delivery.
resultsFive women underwent jejunostomy placement at our institution between 1998 and 2005. One patient underwent jejunostomy placement twice for consecutive pregnancies. The mean body weight loss from prepregnancy was 7.9% (range, 4.0%-15.9%). Patients underwent jejunostomy placement between 12 and 26 weeks of gestation (median 14 weeks). Twelve to 16 Fr catheters were placed in the proximal jejunum. Maternal weight gain occured in 5 of 6 pregnancies. The mean duration of tube placement was 19 weeks (range, 8-28 weeks). All pregnancies ended with term deliveries (range, 36-40 weeks of gestation). The mean infant birth weight was 2885 g (range, 2270-4000 g). Tube-related complications were limited to dislodgement in 2 patients in the third trimester. No cases of infection, bleeding, or preterm labor occured.
conclusionsFeeding via jejunostomy is a potentially safe, effective, and well-tolerated mode of nutrition support therapy in hyperemesis gravidarum.
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