1/24. Enteral nutrition by percutaneous endoscopic gastrojejunostomy in severe hyperemesis gravidarum: a report of two cases.We describe the first two cases in which percutaneous endoscopic gastrojejunostomy was used as a means to provide enteral nutrition in severe hypermesis gravidarum. The use of this method of enteral access provided an alternative to parenteral nutrition, was well tolerated, cost-effective and had no major complications. In both cases the nutritional goal for mothers as well as appropriate fetal growth and development were achieved.- - - - - - - - - - ranking = 1keywords = nutrition (Clic here for more details about this article) |
2/24. Enteral nutrition by nasojejunal tube in hyperemesis gravidarum.We describe two cases in which self-propelling, blind placed nasojejunal tubes were placed in severe hyperemesis gravidarum. This method provides an alternative to parenteral nutrition and to percutaneous endoscopic tubes, is well tolerated, cost effective and with a low rate of complication. Both mothers were given nutritional support at home, had normal subsequent pregnancies and normal babies.- - - - - - - - - - ranking = 0.85714285714286keywords = nutrition (Clic here for more details about this article) |
3/24. Wernicke's encephalopathy due to hyperemesis gravidarum: an under-recognised condition.We present a case of a 25-year-old woman with drowsiness, nystagmus, severe ataxia and areflexia, which developed six weeks after admission to an obstetric clinic for hyperemesis gravidarum. She had been treated with intravenous dextrose and electrolyte solutions and antiemetics. magnetic resonance imaging (MRI) performed on the fifth day of her neurologic symptoms showed increased intensity in both thalami, periaqueductal grey matter, the floor of the fourth ventricle and superior cerebellar vermis in T2 weighted and FLAIR images. Clinical signs and MRI findings were consistent with the diagnosis of Wernicke's encephalopathy. On the third day of thiamine replacement, neurologic signs improved dramatically In addition to our case, we review 29 previously reported cases of Wernicke's encephalopathy associated with hyperemesis gravidarum, and emphasize the importance of thiamine supplementation to women with prolonged vomiting in pregnancy especially if they are given intravenous or parenteral nutrition.- - - - - - - - - - ranking = 0.14285714285714keywords = nutrition (Clic here for more details about this article) |
4/24. hyperemesis gravidarum associated with thyrotoxicosis and a past history of an eating disorder.We present a case of severe hyperemesis gravidarum (HG) associated with thyrotoxicosis in a woman with a past history of an eating disorder. She had developed persistent HG from early pregnancy until about at the end of the second trimester with a body loss of 14 kg. Total parenteral nutrition was effective in alleviateing HG. It is suggested that even a past history of an eating disorder could be at risk of developing HG.- - - - - - - - - - ranking = 0.14285714285714keywords = nutrition (Clic here for more details about this article) |
5/24. Acute renal failure in association with severe hyperemesis gravidarum.BACKGROUND: Severe hyperemesis gravidarum is a rare but potentially devastating complication of pregnancy. Among its many potential complications are dehydration, electrolyte imbalance, malnutrition, wernicke encephalopathy, and compromised renal function. CASE: We report the case of a 21-year-old woman at 15 weeks' gestation presenting to the emergency department with severe hyperemesis gravidarum associated with acute renal failure. Her initial serum creatinine and blood urea nitrogen were 10.7 mg/dL and 171 mg/dL, respectively. The patient underwent daily hemodialysis for 5 days with subsequent return of renal function to normal. CONCLUSION: women with severe hyperemesis gravidarum may be at risk for acute renal failure caused by severe intravascular volume depletion.- - - - - - - - - - ranking = 0.14285714285714keywords = nutrition (Clic here for more details about this article) |
6/24. Solid pseudopapillary pancreatic tumor in pregnancy. A case report.BACKGROUND: Solid pseudopapillary tumor (SPT) of the pancreas is a rare neoplasm, occurring predominantly in young African American women. Tumor growth, which is typically slow, may be accelerated during pregnancy secondary to the influence of progesterone. CASE: We report a rare case of an 8-cm SPT in the head of the pancreas presenting as hyperemesis gravidarum during pregnancy. In contrast to previous case reports, surgical resection of the tumor at 16 weeks' gestation, although successful, did not ameliorate the patient's abdominal pain, nausea or vomiting. With intravenous nutritional support, she delivered a healthy infant near term. CONCLUSION: SPT may present as hyperemesis gravidarum. patients with refractory hyperemesis gravidarum should be evaluated for thyroid disease, gastroesophageal reflux, cholestasis and pancreatitis. If these more common etiologies are excluded, then one may consider SPT in the differential diagnosis, particularly in African American patients. SPT may grow during pregnancy due to progesterone responsiveness. Surgical resection during pregnancy is possible without harmful fetal effects but may not correct gastrointestinal dysfunction during pregnancy.- - - - - - - - - - ranking = 0.14285714285714keywords = nutrition (Clic here for more details about this article) |
7/24. hyperemesis gravidarum presenting as jaundice and transient hyperthyroidism complicated with acute pancreatitis.hyperemesis gravidarum is an extreme form of nausea and vomiting during pregnancy. Its presenting symptoms include vomiting, disturbed nutrition, electrolyte imbalance, ketosis, extreme weight loss, renal and/or liver damage. It is rare for a hyperemesis gravidarum patient to present with jaundice, hyperthyroidism and idiopathic acute pancreatitis during the same hospitalization period. Here, we report such a case. A 25-year-old pregnant woman without underlying liver or thyroid disease was admitted due to jaundice noted for 2 days at 8 weeks of gestational age. hyperthyroidism symptoms of tachycardia and finger tremor also bothered her. After treatment with parenteral fluid and antithyroid agents, her clinical condition improved. However, an episode of idiopathic pancreatitis occurred after nausea and vomiting subsided. Bowel rest with parenteral fluid and nutrition supplement was given and the increased pancreatic enzyme level gradually subsided. Follow-up liver and thyroid function were normal after gestational age of 26 weeks. She delivered a healthy female baby without low birth body weight at gestational age of 39 weeks. Rapid diagnosis and supportive care are important for the hyperemesis gravidarum patient with the complication of acute pancreatitis.- - - - - - - - - - ranking = 0.28571428571429keywords = nutrition (Clic here for more details about this article) |
8/24. Enteral nutrition in hyperemesis gravidarum: a new development.hyperemesis gravidarum occurs in up to 2% of pregnancies. hospitalization is commonly required to treat dehydration and electrolyte and metabolic imbalances. Severe forms of hyperemesis gravidarum involving weight loss greater than 5% of prepregnancy weight have been associated with poor fetal growth and outcome. hyperemesis gravidarum is a high-risk condition from a nutritional perspective. Traditional approaches to nutrition management focus on the cautious introduction of fluids and low-fat solids following resolution of acute nausea and vomiting. When trials of oral feeding fail to be tolerated, consideration should be given to the enteral route as the means of nutritional rehabilitation. A carefully designed delivery regimen combined with antiemetic therapy can prevent abdominal or sensory episodes that might precipitate further vomiting. Two case studies of the successful use of enteral nutrition in hyperemesis gravidarum are presented. Although clinical experience is limited and further research is needed, early results suggest that enteral nutrition in hyperemesis gravidarum is an effective and safe technique.- - - - - - - - - - ranking = 1.2857142857143keywords = nutrition (Clic here for more details about this article) |
9/24. Wernicke's encephalopathy with hyperemesis and ketoacidosis.BACKGROUND: avitaminosis can result from the acute malnutrition associated with prolonged pregnancy-related hyperemesis. Serious complications may arise from thiamine deficiency under these circumstances. CASE: We review the relevant literature and describe a case with central nervous system involvement presenting with typical manifestations of Wernicke's encephalopathy, apparently precipitated by a combination of hyperemesis gravidarum, diabetic ketoacidosis, and intravenous glucose administration. CONCLUSION: While this life-threatening complication is rare, it is important for all who care for obstetric patients to be aware of it and alert to its development. Early recognition is critical given the need to treat affected women expeditiously to help avoid potentially fatal adverse consequences. Prophylactic thiamine supplementation should be considered in the care of gravidas with hyperemesis.- - - - - - - - - - ranking = 0.14285714285714keywords = nutrition (Clic here for more details about this article) |
10/24. candida septicemia in a pregnant woman with hyperemesis receiving parenteral nutrition.BACKGROUND: Intravascular catheter placement carries the risk of a life-threatening systemic fungal infection. In addition to antifungal therapy, removal of the catheter is often considered to be an important part of management. CASE: A 33-year-old multipara with hyperemesis underwent placement of a peripherally inserted central catheter for parenteral nutrition. She subsequently developed candidemia with both blood and the peripherally inserted central catheter tip cultures positive for candida parapsilosis. The catheter was removed, the patient was started on intravenous amphotericin b, and due to side effects, she was switched to intravenous fluconazole. She recovered fully, was discharged home on oral fluconazole, and delivered a healthy infant at term. CONCLUSION: Peripherally inserted central catheter placement may be complicated by candidemia. Intravenous fluconazole and removal of the contaminated catheter successfully eradicated systemic infection with C parapsilosis.- - - - - - - - - - ranking = 0.71428571428571keywords = nutrition (Clic here for more details about this article) |
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