TY - JOUR

T1 - Experience and opinions relating to pregnancy in patients with chronic intestinal failure

T2 - An international survey

AU - Bond, Ashley

AU - Allan, Philip

AU - Conley, Thomas Edward

AU - Farrer, Kirstine

AU - Mackillop, Lucy

AU - Bozzetti, Federico

AU - Cuerda, Cristina

AU - Jeppesen, Palle

AU - Joly, Francisca

AU - Lamprecht, Georg

AU - Mundi, Manpreet

AU - Szczepanek, Kinga

AU - Van Gossum, Andre

AU - Wanten, Geert

AU - Pironi, Loris

AU - Lal, Simon

N1 - Publisher Copyright: © Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2023

Y1 - 2023

N2 - Introduction Pregnancy in patients with chronic intestinal failure (CIF) is a relatively rare occurrence but is an important contemporary topic given both the increasing use of home parenteral nutrition (HPN) and the demographics of patients with CIF. Method An opinion-based survey was produced in a multidisciplinary manner, which was then distributed internationally, via the European Society for Clinical Nutrition and Metabolism network, using a web-based survey tool for healthcare professionals with a specialist interest in the management of CIF. Results Seventy specialists from 11 countries completed the survey. Fifty-four per cent of the respondents reported some experience of managing pregnancy in patients with CIF. However, 60% stated that they did not feel that it was their role to discuss the topic of pregnancy with their patients, with fewer than 10% stating that they routinely did so. Respondents felt that an individualised approach was required when considering alterations to parenteral support prior to conception, during pregnancy and in the postnatal period. Most respondents also felt there was no increased risk of catheter-related blood stream infections, while catheter-related thrombosis was deemed to be the most significant HPN-related complication for pregnant women. Conclusion This study reports a variable experience, knowledge and confidence of healthcare professionals when considering pregnancy in patients with CIF. The risk of HPN-related complication was felt to be greater during pregnancy, with an individualised approach being the preferred route for most aspects of care. The findings support the need for an international registry and subsequent consensus guidelines for the management of pregnancy in CIF.

AB - Introduction Pregnancy in patients with chronic intestinal failure (CIF) is a relatively rare occurrence but is an important contemporary topic given both the increasing use of home parenteral nutrition (HPN) and the demographics of patients with CIF. Method An opinion-based survey was produced in a multidisciplinary manner, which was then distributed internationally, via the European Society for Clinical Nutrition and Metabolism network, using a web-based survey tool for healthcare professionals with a specialist interest in the management of CIF. Results Seventy specialists from 11 countries completed the survey. Fifty-four per cent of the respondents reported some experience of managing pregnancy in patients with CIF. However, 60% stated that they did not feel that it was their role to discuss the topic of pregnancy with their patients, with fewer than 10% stating that they routinely did so. Respondents felt that an individualised approach was required when considering alterations to parenteral support prior to conception, during pregnancy and in the postnatal period. Most respondents also felt there was no increased risk of catheter-related blood stream infections, while catheter-related thrombosis was deemed to be the most significant HPN-related complication for pregnant women. Conclusion This study reports a variable experience, knowledge and confidence of healthcare professionals when considering pregnancy in patients with CIF. The risk of HPN-related complication was felt to be greater during pregnancy, with an individualised approach being the preferred route for most aspects of care. The findings support the need for an international registry and subsequent consensus guidelines for the management of pregnancy in CIF.

KW - INTESTINAL FAILURE

KW - PARENTERAL NUTRITION

UR - http://www.scopus.com/inward/record.url?scp=85152680208&partnerID=8YFLogxK

U2 - 10.1136/flgastro-2023-102384

DO - 10.1136/flgastro-2023-102384

M3 - Journal article

C2 - 37581192

AN - SCOPUS:85152680208

VL - 14

SP - 377

EP - 383

JO - Frontline Gastroenterology

JF - Frontline Gastroenterology

SN - 2041-4137

IS - 5

ER -