NASOGASTRIC ENTERAL FEEDING IN THE MANAGEMENT OF HYPEREMESIS GRAVIDARUM

Objective: To report our experience in treating hyperemesis gravidarum with nasogastric enteral feeding. Methods: Seven women (ages 17-36 ye ars, mean 27 years) presented with intractable nausea, vomiting, dehyd ration, and weight loss (mean 13 lb) and were hospitalized for managem ent 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 r equirements were met. Results: Nausea and vomiting improved within 24 hours after nasogastric tube placement. Enteral feedings were well tol erated, and all patients were discharged from the hospital within 8 da ys. Enteral feedings were continued, in an outpatient setting,for a me an of 43 days (range 5-174). Ultimately, all patients resumed oral fee ding 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 n ausea and vomiting and in providing adequate nutritional support. Ente ral nutrition should be considered as an alternative to total parenter al nutrition in the management of hyperemesis gravidarum.