Hyperemesis gravidarum

From Ganfyd

Jump to: navigation, search

Hyperemesis gravidarum is a severe form of nausea and vomiting complicating pregnancy associated with complex interactions between biological, psychological and sociocultural factors. The most severe form is associated with metabolic disturbance, while the milder forms blur into morning sickness. One clinical definition is of severe nausea and vomiting necessitating hospitalisation with a body weight loss of over 5% from pre-pregnancy weight with ketonuria. The onset is at 10 weeks of gestation or less. Interpreting risk factors and associations[1] is made more difficult by poor epidemiological studies[2]. For example there is no convincing association between it and anxiety or depression[3], but there is a now confirmed association through the maternal line that appears to be genetic[4]. Successfully treated cases appear to have no impact on the fetus.

Contents

Positive associations

Negative associations

  • Maternal smoking
  • Maternal age older than 30

Prevalence

Ethnic variation complicates this as 0.3% in Sweden and 10% in China.

Complications

Treatment

Differential diagnosis

This article is a work in progress. Please feel free to contribute to it.


References

  1. Fell DB, Dodds L, Joseph KS, Allen VM, Butler B. Risk factors for hyperemesis gravidarum requiring hospital admission during pregnancy. Obstetrics and gynecology. 2006 Feb; 107(2 Pt 1):277-84.(Link to article – subscription may be required.)
  2. Sandven I, Abdelnoor M. Critical appraisal of case-control studies of risk factors or etiology of Hyperemesis gravidarum. Archives of gynecology and obstetrics. 2010 Feb 6.(Epub ahead of print) (Link to article – subscription may be required.)
  3. Tan PC, Vani S, Lim BK, Omar SZ. Anxiety and depression in hyperemesis gravidarum: prevalence, risk factors and correlation with clinical severity. European journal of obstetrics, gynecology, and reproductive biology. 2010 Apr; 149(2):153-8.(Link to article – subscription may be required.)
  4. Fejzo MS, Ingles SA, Wilson M, Wang W, MacGibbon K, Romero R, Goodwin TM. High prevalence of severe nausea and vomiting of pregnancy and hyperemesis gravidarum among relatives of affected individuals. European journal of obstetrics, gynecology, and reproductive biology. 2008 Nov; 141(1):13-7.(Link to article – subscription may be required.)
  5. Cedergren M, Brynhildsen J, Josefsson A, Sydsjö A, Sydsjö G. Hyperemesis gravidarum that requires hospitalization and the use of antiemetic drugs in relation to maternal body composition. American journal of obstetrics and gynecology. 2008 Apr; 198(4):412.e1-5.(Link to article – subscription may be required.)
  6. Tan PC, Khine PP, Vallikkannu N, Omar SZ. Promethazine compared with metoclopramide for hyperemesis gravidarum: a randomized controlled trial. Obstetrics and gynecology. 2010 May; 115(5):975-81.(Link to article – subscription may be required.)
  7. Bondok RS, El Sharnouby NM, Eid HE, Abd Elmaksoud AM. Pulsed steroid therapy is an effective treatment for intractable hyperemesis gravidarum. Critical care medicine. 2006 Nov; 34(11):2781-3.(Link to article – subscription may be required.)