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Morning Sickness/Nausea of Pregnancy/Hyperemesis Gravidarum
Published in Charles Theisler, Adjuvant Medical Care, 2023
Nausea is a general term describing a queasy stomach, with or without the feeling that vomiting is likely to occur. Nausea and vomiting are a common symptom and sign that can be caused by a number of different conditions. The nausea and vomiting of pregnancy (morning sickness) typically begin about the fourth to sixth week and often end about the twelfth week. Morning sickness can last longer though. Nausea is often worse in the morning and tends to ease up during the day, but can occur any time of day. For some individuals, the nausea is present throughout the day. Hyperemesis gravidarum is a severe form of morning sickness.
Gastrointestinal diseases and pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Murtaza Arif, Anjana Sathyamurthy, Jessica Winn, Jamal A. Ibdah
Although vomiting may begin before the first missed menstrual period, persistent vomiting requiring hospitalization usually peaks between 8 and 12 weeks of gestation (40,51). Majority of the symptoms resolve by 20 weeks. Patients usually describe typical “morning sickness,” which then becomes more severe and persists throughout the day. Intractable vomiting may lead to development of complications including dehydration and oliguria. Weight loss of more than 5% of prepregnancy weight is usually one of the diagnostic criteria. Physical examination may reveal signs of dehydration with poor skin turgor and tachycardia. Jaundice is occasionally present and the odor of ketones may be noted in the patient’s breath. Neurologic symptoms include changes in mental status ranging from drowsiness to coma, and evidence of peripheral neuropathy due to vitamin B6 or B12 deficiency.
Disorders of the digestive tract
Published in Judy Bothamley, Maureen Boyle, Medical Conditions Affecting Pregnancy and Childbirth, 2020
Up to 45% of women experience vomiting in early pregnancy, with the figure rising to as much as 90% for those who experience nausea alone (Blackburn, 2007). The condition is commonly called morning sickness, reflecting the fact that symptoms are generally worse before eating in the morning, but many women experience symptoms at other times or throughout the day. Nausea and vomiting of pregnancy (NVP) generally starts at around 4–5 weeks of pregnancy, with symptoms peaking at around 12 weeks, and is usually resolved by 16 weeks. Around 20% of women may experience symptoms until term (Miller, 2008). Food aversions to meat, fish, poultry and eggs often accompany NVP.
Cognitive behavior stress management during pregnancy: a randomized controlled trial
Published in Contemporary Nurse, 2019
Jinzhi Li, Dongfang Shao, Xiaoyue Xu, Yu Zhang, Yumin Jiang, John Hall
Our finding that ‘ensuring mother and child health and safety’ is the most important source for stress among pregnant women, which is consistent with another study (Song et al., 2013). Our result is consistent with previous studies that the stress level during the pregnancy was related to the progress of pregnancy (Bennett et al., 2004; Karmaliani et al., 2009). However, studies results were inconsistent regarding when stress reached the highest level during the progress of pregnancy. Our study found that the stress level in late pregnancy was significantly higher than women at the early stage of their pregnancy, which is consistent with Benett and Mowbray’s study results (Mowbray, Bybee, Oyserman, & MacFarlane, 2005; Bennett et al., 2004). However, Silveira’s study demonstrated that the level of stress during the first 16 weeks of pregnancy reached the highest level compared with women at other stages of pregnancy. This may due to adjustment and acceptance by the mother to being pregnant as well as other early pregnancy factors such as morning sickness (Silveira et al., 2013).
Comparison of the groups treated with mirtazapine and selective serotonine reuptake inhibitors with respect to birth outcomes and severity of psychiatric disorder
Published in Psychiatry and Clinical Psychopharmacology, 2019
Buket Belkız Güngör, Nalan Öztürk, Ayça Öngel Atar, Nazan Aydın
Up to now, SSRIs have been used as the first-line option by clinicians when anxiety and depressive disorders are treated pharmacologically during pregnancy [9]. On the other hand, the guidelines are unclear in terms of selecting a first-line drug, switching antidepressants or pregnancy-specific recommendations, and no evidence-based consensus has been reached [10]. SSRIs could aggravate morning sickness by causing gastrointestinal system irritation at the initiation of the treatment. While using SSRI, it may be required to wait for a period of time until treatment response for anxiety and depression. Antihistaminic agents and benzodiazepines could be necessary adding to the treatment in patients with severe symptoms at the beginning of the treatment with SSRIs. However, at the beginning of the treatment mirtazapine may contribute to decreased nausea, decreased symptoms of anxiety and the alleviation of insomnia. The pharmacological properties of mirtazapine offer a treatment option without the need to use anxiolytic and hypnotic agents. The importance of monotherapy increases at pregnancy.
Antimalarial drugs for treating and preventing malaria in pregnant and lactating women
Published in Expert Opinion on Drug Safety, 2018
Makoto Saito, Mary Ellen Gilder, Rose McGready, François Nosten
The adverse symptoms of quinine are collectively called cinchonism, which affects almost all patients [16]. This leads to poor adherence particularly among the pregnant women in the first trimester when morning sickness peaks. The actual adherence without supervision is thought to be poor [7]. The prevalence of tinnitus in pregnant patients on quinine is reported to be from 35% to 85% in > 450 patients assessed in seven studies [11–13,15,17–19]. A meta-analysis reported that the risks of tinnitus (pooled RR 4.70, 95% CI 1.20–18.39, five RCTs), vomiting (pooled RR 2.01, 95%CI 1.23–3.30, five RCTs) and dizziness (pooled RR 1.51, 95% CI 1.02–2.25, three RCTs) were higher than those of artemisinin-based treatment [10]. Nausea and anorexia are also more common with quinine than artemether-lumefantrine (AL) in an open-label RCT [12]. The risk of quinine related hypoglycemia is higher in pregnant women than the general population, particularly in cases with severe malaria [20,21]. For uncomplicated malaria, two studies reported that hypoglycemia was observed in 17% (4/24) [18] – 72% (21/29) [14], but symptomatic hypoglycemia was rare (0/246) [17]. To reduce side effects under-dosing treatment by prescribing twice daily dosing or only five days is potentially harmful and likely to induce resistance [7,18]. In a study in Uganda, QTc prolongation (Fridericia corrected QTc > 440 ms) was observed on day 2 in 1% (2/149) of the patients [12].