Percutaneous Endoscopic Gastrostomy for Nutrition Support in Pregnancy Associated With Hyperemesis Gravidarum and Anorexia Nervosa

Godil, Aslam; Chen, Yang K.

doi:10.1177/0148607198022004238

Cited by 39 publications

(15 citation statements)

References 26 publications

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“…115 The literature reveals six reports of patients undergoing PEG during pregnancy (see Supplementary Table 5 online). [116][117][118][119] Indications for this procedure were failure to eat orally due to one of the following: advanced amyotrophic lateral sclerosis, anorexia nervosa, hyperemesis gravidarum, nausea and vomiting from myotonic muscular dystrophy, profound neurologic injury from a motor vehicle accident, and odynophagia from severe circumferential esophagitis. Five of the six pregnancies had a favorable outcome, despite generally severe maternal conditions.…”

Section: Percutaneous Endoscopic Gastrostomymentioning

confidence: 99%

Risks versus benefits of gastrointestinal endoscopy during pregnancy

Cappell

2011

Nat Rev Gastroenterol Hepatol

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Although gastrointestinal endoscopy is generally safe, its safety must be separately analyzed during pregnancy with regard to fetal safety. Fetal risks from endoscopic medications are minimized by avoiding FDA category D drugs, minimizing endoscopic medications, and anesthesiologist attendance at endoscopy. Esophagogastroduodenoscopy seems to be relatively safe for the fetus and may be performed when strongly indicated during pregnancy. Despite limited clinical data, endoscopic banding of esophageal varices and endoscopic hemostasis of nonvariceal upper gastrointestinal bleeding seems justifiable during pregnancy. Flexible sigmoidoscopy during pregnancy also appears to be relatively safe for the fetus and may be performed when strongly indicated. Colonoscopy may be considered in pregnant patients during the second trimester if there is a strong indication. Data on colonoscopy during the other trimesters are limited. Therapeutic endoscopic retrograde cholangiopancreatography seems to be relatively safe during pregnancy and should be performed for strong indications (for example, complicated choledocholithiasis). Endoscopic safety precautions during pregnancy include the performance of endoscopy in hospital by an expert endoscopist and only when strongly indicated, deferral of endoscopy to the second trimester whenever possible, and obstetric consultation.

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Section: Percutaneous Endoscopic Gastrostomymentioning

confidence: 99%

Risks versus benefits of gastrointestinal endoscopy during pregnancy

Cappell

2011

Nat Rev Gastroenterol Hepatol

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“…97,98 Case reports have described the safe use of PEG and PEGJ tubes in pregnant women. [99][100][101] Complications associated with PEG tube placement include wound infections, injury to adjacent organs, gastrocolonic fistula, and bleeding. Postprocedure pneumoperitoneum has a reported incidence of 5.4%, but most cases are benign and not considered a complication.…”

Section: Safetymentioning

confidence: 99%

Enteral nutrition access devices

Kwon¹,

Banerjee²,

Desilets³

et al. 2010

Gastrointestinal Endoscopy

115

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“…Indicações menos comuns como anorexia nervosa e hiperemese gravídica, também têm sido referidas como beneficiadas com o uso da GEP (12,29) . A indicação de GEP tem sido precoce em determinados serviços em que atua equipe multidisciplinar de terapia nutricional, ocorrendo, por vezes, após 3 semanas a partir da introdução da nutrição enteral (21) .…”

Section: Discussionunclassified

“…A manutenção ou ganho do peso corpóreo foi observada em pacientes com anorexia nervosa e hiperemese gravídica (12,29) , síndrome da imunodeficiência adquirida (6) e pacientes oncológicos (22) . Nesta série, a manutenção do peso corpóreo e estabilização dos dados bioquímicos demonstraram a eficiência do procedimento no sentido de manutenção do estado nutricional dos pacientes submetidos a GEP.…”

Section: Discussionunclassified

Gastrostomia endoscópica em pacientes com cardiopatia complicada

Cukier¹,

Magnoni²,

Poletti³

et al. 2000

Arq. Gastroenterol.

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INTRODUÇÃOPacientes cardiopatas podem desenvolver complicações cardíacas e sistêmicas com conseqüente repercussão negativa sobre o estado nutricional. Entre as cardiopatias com potencial de desnutrição encontram-se as síndromes relacionadas à insuficiência cardíaca congestiva, pós-operatório complicado de cirurgia cardíaca, patologias congênitas (transposição dos grandes vasos, comunicação interatrial, comunicação interventricular) limitação crônica ao fluxo aéreo, entre outras. Como complicação, pacientes cardiopatas desenvolvem inanição relacionada à caquexia da insuficiência cardíaca e alterações vasculares cerebrais isquêmicas e hemorrágicas. Essas situações serão de indicação precisa de tratamento nutricional enteral ou parenteral.Estabelecida a necessidade de terapia nutricional e possibilidade do uso da nutrição enteral, deve-se decidir pela via de acesso ao tubo digestivo. Inicialmente, opta-se pelo uso da sonda enteral locada em posição pré ou pós-pilórica, dependendo das condições do paciente e objetivos da terapia nutricional. O uso prolongado da sonda enteral, entretanto, pode proporcionar complicações mecânicas como erosão nasal e necrose, abscesso septonasal, sinusite aguda, rouquidão, otite, faringite, esofagite, ulceração e estenose esofágica, fístula traqueoesofágica, ruptura de varizes esofágicas, obstrução da sonda, saída ou migração acidental da mesma (5) .

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Percutaneous Endoscopic Gastrostomy for Nutrition Support in Pregnancy Associated With Hyperemesis Gravidarum and Anorexia Nervosa

Abstract: Our observation is the first demonstration that PEG may be a safe and effective alternative to TPN in selected pregnant women with HEG or anorexia nervosa who have failed conventional treatment.

Cited by 39 publications

References 26 publications

Risks versus benefits of gastrointestinal endoscopy during pregnancy

Risks versus benefits of gastrointestinal endoscopy during pregnancy

Enteral nutrition access devices

Gastrostomia endoscópica em pacientes com cardiopatia complicada

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