P115 - FOURTEEN YEARS, ONE CATHETER, AND A NEW LIFE: FIRST DOCUMENTED PREGNANCY AND DELIVERY ON HOME PARENTERAL NUTRITION IN LITHUANIA AND THE BALTIC STATES

P115

FOURTEEN YEARS, ONE CATHETER, AND A NEW LIFE: FIRST DOCUMENTED PREGNANCY AND DELIVERY ON HOME PARENTERAL NUTRITION IN LITHUANIA AND THE BALTIC STATES

G. Babravičienė^1,* on behalf of E. Gavelienė, MD, PhD, Prof. V. Urbonas, MD, prof. T. Poškus, MD, G. Kėkštas, MD, Assoc. Prof. V. Paliulytė, MD, Vilnius University Hospital Santaros klinikos

¹Department of Malnutrition treatment and prevention, Vilnius University Hospital Santaros klinikos, Vilnius, Lithuania

Rationale: Successful pregnancy in patients on long-term total parenteral nutrition (TPN) due to chronic intestinal failure is rare and poses complex clinical challenges. We report the first documented case of a successful pregnancy and delivery in a TPN-dependent patient in the Baltic States.

Methods: This is a retrospective case report of a female patient with chronic intestinal failure, diagnosed with pseudoobstruction and malabsorption in 2004 and treated with terminal ileostomy and TPN since 2011. Clinical data were collected from medical records over a 20-year follow-up period, including TPN management, catheter-related outcomes, nutritional status, liver function, pregnancy course, and delivery outcome.

Results: The patient began TPN via a tunneled Hickman catheter in the right femoral vein in 2011 and has maintained the same catheter with occasional repairs for 14 years. Due to liver enzyme elevation, the TPN regimen was switched from a multi-bottle system to an All-in-One system in 2021, leading to normalization of liver function. In 2023, she conceived spontaneously and delivered a healthy newborn. Failed labor induction led to an emergency cesarean section, complicated by intra-abdominal adhesions; postoperative recovery was uneventful.

Conclusion: This case demonstrates that long-term TPN can support survival and successful pregnancy outcomes, even with extended central venous catheter use. It underscores the importance of individualized, multidisciplinary care in managing chronic intestinal failure, including timely adaptation of TPN regimens to prevent complications. This report provides encouraging evidence that positive reproductive outcomes are achievable in carefully managed patients with complex nutritional needs.

Disclosure of Interest: None declared