PERCUTANEOUS ENDOSCOPIC GASTROSTOMY FOR NUTRITION SUPPORT IN PREGNANCY-ASSOCIATED WITH HYPEREMESIS GRAVIDARUM AND ANOREXIA-NERVOSA

Background: Pregnant women with hyperemesis gravidarum (HEG) or anorex ia nervosa are at high risk of developing malnutrition and adverse fet al outcome. Providing adequate nutrition support is the mainstay of th erapy in these patients. Because of potential complications associated with total parenteral nutrition (TPN), enteral nutrition support is t he preferred route. Methods:We describe the first two reported cases o f percutaneous endoscopic gastrostomy (PEG) placement in two conscious pregnant women who could not tolerate oral. feedings because of sever e anorexia nervosa and HEG, respectively. Results: PEG was placed safe ly and provided adequate enteral nutrition in both patients, resulting in favorable maternal and fetal outcomes. Conclusions: Our observatio n is the first demonstration that PEG may be a safe and effective alte rnative to TPN in selected pregnant women with HEG or anorexia nervosa who have failed conventional treatment.