Question

[jacquelynb]

I have been pg 4 times. I have had hg with all. The first was our son Aidan. I miscarried the other 3. My question is this. Is there any connection between tpn and miscarriage? I had tpn with our son Aidan, he was perfect. I had tpn again for the third pg and miscarried. The fourth pg I did not receive tpn, even though it was my most severe hg to date. We had a new ob and he felt tpn dramatically increased the risk of miscarriage. Just wondering what others have experienced and why he might feel so strongly about this, what research he was basing this on. (I plan on asking our ob this as well, just haven't had a chance yet.) As we have miscarried both on and off tpn, I'm not sure what difference it really makes for me.

Not sure if this is the correct place to post this. Sorry if it is not.

[justme]

I also put this in ask the admin folder to see if you would get some good info. I think there is a study somewhere here that talks about increased neurological damage with tpn (?) - but I am not sure. A very cursory google search indicates that tpn is linked to miscarriage. But these are not medical journals. Also, there are women here who have been on tpn and had healthy babies. I would maybe make an appointment with a maternal fetal medicine specialist and get another opinion and talk to them about making a plan should you want to try again.

edited to add: The study that I am thinking of actually indicates that poor maternal nutrition can lead to negative fetal programming. Thus, tpn is a better alternative to no nutrition in severe hg cases I would think. A brief search on pubmed seems to indicate that tpn can help prevent pregnancy loss . . .

Hugs,
Karen

[aaronsmommy]

I think the studies we have suggest that being sick enough to need TPN puts you at risk for miscarriage. TPN is not perfect nutrition and it is certainly possible that it is missing something that is important for fetal development, but if the alternative is no nutrition, or extremely poor nutrition because you can't eat, it is hard to see how the TPN would not be better than that.
There are few studies looking at outcomes for the baby with TPN, and the important question would be what is the alternative?

I have had a miscarriage at 18 weeks on TPN and one healthy baby with TPN. I am sure that for me the alternative would have been both of us dying.

[jacquelynb]

"The studies we have suggest that being sick enough to need TPN puts you at risk for miscarriage. TPN is not perfect nutrition and it is certainly possible that it is missing something that is important for fetal development, but if the alternative is no nutrition, or extremely poor nutrition because you can't eat, it is hard to see how the TPN would not be better than that."

This is always what we were told before by our previous ob. It was very upsetting when our new ob blamed our miscarriage on the tpn. He made me feel like I was at fault. Basically saying that we wouldn't have miscarried if I hadn't used tpn. I wasn't even his patient then. So I don't see how he could make this claim with such certainty. Just wanted to make sure we weren't missing something. I don't think we will return to him the next time.

By the way justme, we did see a specialist and had a very aggressive treatment plan. But unfortunately, we had trouble getting our insurance to cover her and so we were forced to see the other doctor who was not "comfortable" with our treatment plan. He refused to even consult the specialist we had previously seen. He fought with us every step of the way about everything. He kept telling us that the treatments I had before a pic line, home health care, tpn, etc. were "extreme" and only necessary for the sickest hg patients. Even when he watched me getting sicker by the day. It was so frustrating and stressful.