{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T17:50:53Z","timestamp":1760982653309,"version":"build-2065373602"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[1986,11,1]],"date-time":"1986-11-01T00:00:00Z","timestamp":531187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[1986,11]]},"abstract":"<jats:p>A 27\u2010yr\u2010old gravida 3, para 2 was supported from the 8th week of pregnancy by intermittent daily total parenteral nutrition (TPN) following the loss of her small bowel. Nutrient intake was adjusted by monitoring nitrogen balance and the rate of increase in fetal cranial enlargement. Maternal calcium balance proved difficult to maintain, since massive urinary Ca<jats:sup>+2<\/jats:sup> losses occurred during infusion of nutrients (576 \u00b1 2 mg\/12 hr on TPN compared to 47 \u00b1 12 mg\/12 hr off). This increase in urine Ca<jats:sup>+2<\/jats:sup> was due to depressed Ca<jats:sup>+2<\/jats:sup> reabsorption by the kidney (87.1 \u00b1.7 us 98.1 \u00b1.3%) and increased filtered load (4623 \u00b1 241 mg\/12 hr us 2591 \u00b1 329). Initially calcium balance was \u2010180 mg\/day. Nitrogen balance assessed by total stool and urine nitrogen was 1.1 g\/24 hr, which was judged to be suboptimal. Deficits were corrected by increasing nitrogen intake, lengthening the duration of infusion and the oral administration of elemental calcium during periods off infusion. A normal fetus was delivered vaginally without complications at 35\u00bd weeks. This patient demonstrates that normal fetal growth and development as well as appropriate maternal weight gain and nitrogen balance can be maintained throughout pregnancy, including the first trimester, by intermittent daily TPN. 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