P122 - HOME PARENTERAL NUTRITION IN A PREGNANCY: DATA FROM CZECH REGISTRY

P122

HOME PARENTERAL NUTRITION IN A PREGNANCY: DATA FROM CZECH REGISTRY

M. Machava^1,*, D. Čermáková¹, P. Kohout¹

¹Dept. of Internal Medicine, 3rd Faculty of Medicine, Charles University, Thomayer University Hospital, Prague, Czech Republic

Rationale: Home parenteral nutrition (HPN) is a life-sustaining therapy used when enteral nutrition (EN) is insufficient or impossible. In favorable cases, HPN is administered temporarily, serving as a bridge during periods of nutritional insufficiency. A systematic review of the literature shows that the use of HPN during pregnancy is rarely reported, and the patient population is quite heterogeneous (e.g., short-term HPN in hyperemesis gravidarum (HG), ileus, or long-term HPN in SBS or Crohn’s disease), contributing to the limited clinical experience and the absence of standardized guidelines in this area.

Methods: Data are currently being collected in cooperation with Czech HPN centers and the national registry “REDNUP.” A retrospective analysis of seven cases over the past 22 years aims to evaluate individualized HPN approaches in pregnancy. Medical records will be reviewed for biological parameters, PN type and dosage, and adjustments per guidelines for healthy pregnant women. Complications, such as bloodstream infections or metabolic disturbances, will also be assessed.

Results: Among the seven cases, two pregnancies are currently ongoing, four resulted in successful deliveries, and one ended in spontaneous abortion during the first trimester. In two cases, short-term HPN was initiated due to prolonged HG; one case involved ileus from adhesions; and the remaining patients were already on long-term HPN prior to pregnancy. The estimated average daily energy intake was approximately 27.5 kcal/kg with 1 g/kg of protein during the first trimester, increasing to 32–35 kcal/kg and 1.3 g/kg of protein in the second and third trimesters. Doses were adjusted according to maternal and fetal weight gain, as well as laboratory results.

Conclusion: This analysis highlights that the indication for HPN during pregnancy is rare but a safe method with favorable outcomes, though the needs of both the mother and the fetus must be carefully considered.

Disclosure of Interest: None declared