Contemporary approaches to hyperemesis during pregnancy
- 1 April 2011
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Current Opinion in Obstetrics and Gynecology
- Vol. 23 (2), 87-93
- https://doi.org/10.1097/gco.0b013e328342d208
Abstract
Nausea and vomiting of pregnancy (NVP) affects 90% of pregnant women and its impact is often underappreciated. Hyperemesis gravidarum, the most severe end of the spectrum, affects 0.5-2% of pregnancies. The pathogenesis of this condition remains obscure and its management has largely been empirical. This review aims to provide an update on advances in pregnancy hyperemesis focusing on papers published within the past 2 years. The cause of hyperemesis is continuing to be elaborated. Recent data attest to the effectiveness of the oral doxylamine-pyridoxine in NVP. Follow-up data of children exposed in early pregnancy to doxylamine-pyridoxine for NVP are reassuring. Evidence is increasing for ginger as an effective herbal remedy for NVP. Metoclopramide is effective in NVP and hyperemesis gravidarum, with a good balance of efficacy and tolerability. A recent large-scale study on first trimester exposure to metoclopramide is reassuring of its safety. Evidence is emerging for the treatment of acid reflux to ameliorate NVP. The role of corticosteroids for hyperemesis gravidarum remains controversial. Transpyloric feeding may be warranted for persistent weight loss, despite optimal antiemetic therapy. Women with significant NVP should be identified so that they can be safely and effectively treated.Keywords
This publication has 46 references indexed in Scilit:
- Severity and duration of nausea and vomiting symptoms in pregnancy and spontaneous abortionHuman Reproduction, 2010
- Biological functions of hCG and hCG-related moleculesReproductive Biology and Endocrinology, 2010
- Epidemiology of nausea and vomiting of pregnancy: prevalence, severity, determinants, and the importance of race/ethnicityBMC Pregnancy and Childbirth, 2009
- Feeding Jejunostomy for the Treatment of Severe Hyperemesis Gravidarum: A Case SeriesJournal of Parenteral and Enteral Nutrition, 2009
- Psychiatric consultation of patients with hyperemesis gravidarumArchives of Women's Mental Health, 2009
- The Effect of Acid-Reducing Pharmacotherapy on the Severity of Nausea and Vomiting of PregnancyObstetrics and Gynecology International, 2009
- The Safety of Histamine 2 (H2) Blockers in Pregnancy: A Meta-analysisDigestive Diseases and Sciences, 2008
- High prevalence of severe nausea and vomiting of pregnancy and hyperemesis gravidarum among relatives of affected individualsEuropean Journal of Obstetrics & Gynecology and Reproductive Biology, 2008
- Consanguinity and the risk of hyperemesis gravidarum in NorwayActa Obstetricia et Gynecologica Scandinavica, 2008
- Outcomes of Pregnancies Complicated by Hyperemesis GravidarumObstetrics & Gynecology, 2006