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<Journal>
<PublisherName>jmedicalcasereports</PublisherName>
<JournalTitle>Frontiers in Medical Case Reports</JournalTitle>
<PISSN>I</PISSN>
<EISSN>S</EISSN>
<Volume-Issue>Volume 3; Issue 2</Volume-Issue>
<PartNumber/>
<IssueTopic>Multidisciplinary</IssueTopic>
<IssueLanguage>English</IssueLanguage>
<Season>(Mar-Apr, 2022)</Season>
<SpecialIssue>N</SpecialIssue>
<SupplementaryIssue>N</SupplementaryIssue>
<IssueOA>Y</IssueOA>
<PubDate>
<Year>-0001</Year>
<Month>11</Month>
<Day>30</Day>
</PubDate>
<ArticleType>Surgical Case Reports</ArticleType>
<ArticleTitle>Managing Home Parenteral Nutrition during Pregnancy in Patient with Short Bowel Syndrome: Case Report of a Successful Experience in Sabah, Malaysia</ArticleTitle>
<SubTitle/>
<ArticleLanguage>English</ArticleLanguage>
<ArticleOA>Y</ArticleOA>
<FirstPage>1</FirstPage>
<LastPage>8</LastPage>
<AuthorList>
<Author>
<FirstName>Pui Wun Fiona</FirstName>
<LastName>Fong</LastName>
<AuthorLanguage>English</AuthorLanguage>
<Affiliation/>
<CorrespondingAuthor>N</CorrespondingAuthor>
<ORCID/>
<FirstName>Stella Caroline</FirstName>
<LastName>Bangguan</LastName>
<AuthorLanguage>English</AuthorLanguage>
<Affiliation/>
<CorrespondingAuthor>Y</CorrespondingAuthor>
<ORCID/>
<FirstName>Kaai Yirng</FirstName>
<LastName>Hwang</LastName>
<AuthorLanguage>English</AuthorLanguage>
<Affiliation/>
<CorrespondingAuthor>Y</CorrespondingAuthor>
<ORCID/>
<FirstName>Sharmila</FirstName>
<LastName>Seenivasagam</LastName>
<AuthorLanguage>English</AuthorLanguage>
<Affiliation/>
<CorrespondingAuthor>Y</CorrespondingAuthor>
<ORCID/>
<FirstName>Ratha Krishnan</FirstName>
<LastName>Sriram</LastName>
<AuthorLanguage>English</AuthorLanguage>
<Affiliation/>
<CorrespondingAuthor>Y</CorrespondingAuthor>
<ORCID/>
<FirstName>Kong Yong</FirstName>
<LastName>Chong</LastName>
<AuthorLanguage>English</AuthorLanguage>
<Affiliation/>
<CorrespondingAuthor>Y</CorrespondingAuthor>
<ORCID/>
</Author>
</AuthorList>
<DOI/>
<Abstract>Short bowel syndrome (SBS) is one of the pathophysiological mechanisms of chronic intestinal failure (IF) which warrants long-term parenteral nutrition (PN). Despite the common use of PN, there has been few literature on PN use for IF patients since before pregnancy. Our patient was diagnosed with gangrenous bowel secondary to congenital malrotation in 2015. Extensive bowel resection resulted in SBS requiring lifelong home PN. In February 2020, patient discovered her pregnancy and PN pharmacists were informed. Energy from PN was increased with addition of multivitamins, trace elements (TEs) and electrolytes tailored to weekly blood results. At gestation week 34, 24-hour urine urea test showed positive nitrogen balance of +3g/day, demonstrating adequate supply from PN. At gestation week 37, a small-for-gestational-age female infant was delivered via spontaneous labour. Apgar score demonstrated excellent condition and the infant managed to thrive subsequently. Patient’s pre-pregnancy underweight status and insufficient weight gain throughout pregnancy are believed to have put her at higher risk for low-birth-weight infant. Vitamins and TEs supplementation generally met the recommendation for pregnancy, which is however established for oral/enteral intake. This case report proved that successful pregnancy is possible in SBS patients on HPN with close monitoring and effective communication with patient.</Abstract>
<AbstractLanguage>English</AbstractLanguage>
<Keywords>Home Parenteral Nutrition,Nutritional Support,Pregnancy,Short Bowel Syndrome,Case Report</Keywords>
<URLs>
<Abstract>https://www.jmedicalcasereports.org/ubijournal-v1copy/journals/abstract.php?article_id=13624&title=Managing Home Parenteral Nutrition during Pregnancy in Patient with Short Bowel Syndrome: Case Report of a Successful Experience in Sabah, Malaysia</Abstract>
</URLs>
<References>
<ReferencesarticleTitle>References</ReferencesarticleTitle>
<ReferencesfirstPage>16</ReferencesfirstPage>
<ReferenceslastPage>19</ReferenceslastPage>
<References>Bond A, Vasant D, Gashau W, Abraham A, Teubner A, Farrer K, Leahy G, Lal S. Managing Successful Pregnancies in Patients with Chronic Intestinal Failure on Home Parenteral Nutrition: Experience from a UK National Intestinal Failure Unit. J Gastrointestin Liver Dis 2017; 26: 375-379.
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Carrasco-Rojas JA, Tapia-Jurado J, Leroy-Land;oacute;pez L, Ruand;iacute;z-Lizarraga J. Pregnancy and short bowel syndrome treated with parenteral nutrition. Cir Cir 2016; 84: 3-8.
Dickerson RN. Nitrogen balance and protein requirements for critically ill older patients. Nutrients 2016; 8: 226.
Gulec S, Anderson GJ, Collins JF. Mechanistic and regulatory aspects of intestinal iron absorption. Am J Physiol Gastrointest Liver Physiol 2014; 307: G397-G409.
Pironi L, Arends J, Baxter J, Bozzetti F, Peland;aacute;ez RB, Cuerda C, Forbes A, Gabe S, Gillanders L, Holst M, Jeppesen PB. ESPEN endorsed recommendations. Definition and classification of intestinal failure in adults. Clin Nutr 2015; 34: 171-180.
Sriram K and Lonchyna VA. Micronutrient supplementation in adult nutrition therapy: practical considerations. JPEN J Parenter Enteral Nutr 2009; 33: 548-562.
Web Links
Medscape (2018). Prenatal Nutrition [Online]. Available at: https://emedicine.medscape.com/article/259059-overview [Accessed 28 July 2021].
Medscape (2021). Short-Bowel Syndrome Treatment and; Management: Approach Considerations, Medical Therapy, Surgical Therapy [Online]. Available at: https://emedicine.medscape.com/article/193391-treatment#d9 [Accessed 28 July 2021].
Smith JA, Fox KA, Clark SM (2022). Nausea and vomiting of pregnancy: Treatment and outcome. [online] Uptodate.com. Available at: https://www.uptodate.com/contents/nausea-and-vomiting-of-pregnancy-treatment-and-outcome [Accessed 20 August 2021].</References>
</References>
</Journal>
</Article>
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