Objective: We evaluated pregnancy outcome and fetal growth in women requiring total parenteral nutrition (TPN). Methods: Eleven malnourished pregnant women were treated with TPN in a single institution, starting at a mean gestational age of 20 ± 8 weeks (± SD). Serial ultrasound evaluations of fetal growth (biparietal diameter, femur length, abdominal circumference) were performed. The paired Student t test and Wilcoxon signed-rank test were used for the statistical analysis: p values <0.05 were considered significant. Results: The duration of TPN ranged from 14 to 220 days. Maternal nutritional state was well preserved and no complications were related to treatment. A gestational age of 35 ± 3 weeks at delivery (mean ± SD), birth weight of 2,251 ± 670 g (mean ± SD) and birth percentile of 29 ± 16 (mean ± SD) were observed. One intrauterine death occurred. The comparison between the sonographic findings, before and 2 weeks after starting TPN, showed a fetal percentile gain with a statistically significant increase in the abdominal circumference percentile (p < 0.05) from a median percentile of 2 (range 2–32) to 33 (range 2–78). Conclusions: TPN proved to be helpful and lifesaving in malnourished pregnant women and promoted fetal growth, as shown by the longitudinal ultrasonographic evaluations.

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