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Nutritional and Dietary Supplementation during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
All pregnant women probably experience nausea to some degree in early pregnancy. “Morning sickness” or nausea and vomiting are common symptoms during the first trimester of pregnancy, but most pregnant women do not require antiemetic therapy. Frequent, small meals may prove beneficial in management of nausea without medical intervention. Fortunately, hyperemesis gravidarum, the most severe form of pregnancy-associated nausea and vomiting occurs in only a small percentage of gravidas. Women with hyperemesis gravidarum may require hospitalization and intravenous hydration, and antiemetic therapy. One of the most effective antiemetic agents for nausea and vomiting associated with pregnancy was doxylamine plus pyridoxine (Bendectin). However, this agent is no longer available because of the fear of litigation. When antiemetics are indicated, promethazine suppositories (or occasionally use of oral preparations) in doses of 25 mg should be used. Other agents that may prove useful for hyperemesis gravidarum are given in Box 12.4.
Nausea/Vomiting of Pregnancy and Hyperemesis Gravidarum
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Diagnosis of hyperemesis gravidarum is nausea and vomiting ≥3 times a day, with large ketones in urine or acetone in blood (dehydration, fluid, and electrolytes changes), and weight loss of >3 kg or >5% pre-pregnancy weight, having excluded other diagnoses.
Pregnancy, Delivery and Postpartum
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Zahra Ameen, Katy Kuhrt, Kopal Singhal Agarwal, Chawan Baran, Rebecca Best, Maria Garcia de Frutos, Miranda Geddes-Barton, Laura Bridle, Black Benjamin
Nausea and vomiting in pregnancy (NVP) should only be diagnosed when onset is in the first trimester of pregnancy and other causes of nausea and vomiting have been excluded. Hyperemesis gravidarum can be diagnosed when there is protracted NVP with the triad of more than 5% pre-pregnancy weight loss, dehydration and electrolyte imbalance.8
Women’s perspectives on the management and consequences of hyperemesis gravidarum – a descriptive interview study
Published in Scandinavian Journal of Primary Health Care, 2019
Gro C. Havnen, Maria Bich-Thuy Truong, Mai-Linh H. Do, Kristine Heitmann, Lone Holst, Hedvig Nordeng
A total of 210 women consented to participate in the study, and 153 interviews were performed. The interviews lasted an average of 48 minutes, ranging from 25 to 120 minutes. Of these, 107 women met the inclusion criteria and were included in the final study sample, and 96 women (89.7%) completed the online questionnaire. A flowchart outlining the patient inclusions and exclusions that led to the final study sample is depicted in Appendix Figure 1. The average age of study participants was 30.5 ± 4.5 years. Participants were mostly married, cohabiting, or in a relationship (92/96, 95.8%), had a university or college education (60/96, 62.5%), and were not pregnant (76/107, 71.0%) at the time of study inclusion (Appendix Table 1). Nearly 3 out of 4 women (77/107, 72.0%) had experienced hyperemesis gravidarum (HG) during the year prior to the study. Thirteen women with more than one HG pregnancy chose to focus on their first experience with HG.
A case of prolonged hyperemesis resulting in hepatorenal failure, foetal distress and neonatal mortality
Published in Journal of Obstetrics and Gynaecology, 2018
Hyperemesis gravidarum, defined as a condition emerging during pregnancy, leads to severe nausea and vomiting, a water-electrolyte imbalance and a liver-kidney function disorder, and it causes more than a 5% loss of body weight (Goodwin 1998). Hyperemesis gravidarum affects 0.5–10 out of 1000 pregnant women (Broussard and Richter 1998). It usually emerges in the first trimester and most cases recover around week 20, although some cases continue through full pregnancy (American College of Obstetrics and Gynecology 2004). In cases of severe hyperemesis gravidarum, maternal morbidities, such as a water-electrolyte imbalance, hepatorenal failure, Wernicke’s encephalopathy, splenic avulsion, oesophageal rupture and pneumothorax, were reported (Eroglu et al. 2002; Di Gangi et al. 2012). In addition, in cases of severe hyperemesis gravidarum, small gestational age (SGA), preterm birth, intrauterine growth retardation and pregnancy-related hypertension are among the expected foetal complications (Veenendaal et al. 2011).
Effect of advanced maternal age on pregnancy outcomes: a single-centre data from a tertiary healthcare hospital
Published in Journal of Obstetrics and Gynaecology, 2019
Ahkam Göksel Kanmaz, Abdurrahman Hamdi İnan, Emrah Beyan, Suriye Ögür, Adnan Budak
In our study, it was determined that the significant increased relative risk of first trimester bleeding was in 45 years and above multiparous group. One of the possible mechanism may be affected progesterone levels at first trimester because of lack of corpus gravidarum due to increased rates of ART pregnancies at advanced maternal age (De Sutter et al. 2006) and the other possible mechanism is the aging of endometrium and ovarian follicle (Yang J et al. 2005). Likewise, hyperemesis gravidarum risk increase more in multiparous advanced maternal age pregnancies. Our results about hyperemesis gravidarum was contrary to the literature (Bolin et al. 2013; Petry et al. 2018). Social demographic differs may have a role for the different results about hyperemesis gravidarum in our study.