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Nasogastric Enteral Feeding in the Management of Hyperemesis Gravidarum

HSU, JOSEPH J. MD; CLARK-GLENA, RENE LPN; NELSON, DANIEL K. MS; KIM, CHUNG H. MD
Obstetrics & Gynecology: September 1996
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Objective To report our experience in treating hyperemesis gravidarum with nasogastric enteral feeding.

Methods Seven women (ages 17–36 years, mean 27 years) presented with intractable nausea, vomiting, dehydration, and weight loss (mean 13 1b) and were hospitalized for management of symptoms and nutritional support. An 8-Fr Dobbhoff nasogastric feeding tube was placed and nutritional supplement was administered as a continuous infusion, starting at a rate of 25 mL/hour. The rate of infusion was increased in an incremental fashion until daily caloric requirements were met.

Results Nausea and vomiting improved within 24 hours after nasogastric tube placement. Enteral feedings were well tolerated, and all patients were discharged from the hospital within 8 days. Enteral feedings were continued, in an outpatient setting, for a mean of 43 days (range 5–174). Ultimately, all patients resumed oral feeding and discontinued enteral feeding. Subsequently, all patients gave birth to full-term, normal-weight babies.

Conclusion Enteral feeding via nasogastric tube seems to be effective in relieving intractable nausea and vomiting and in providing adequate nutritional support. Enteral nutrition should be considered as an alternative to total parenteral nutrition in the management of hyperemesis gravidarum.

Address reprint requests to: Daniel K. Nelson, MS, Isaac Gordon Center for Digestive Diseases and Nutrition, The Genesee Hospital, 224 Alexander Street, Rochester, NY 14607

© 1996 The American College of Obstetricians and Gynecologists