Presentation
The present review aims to present the scientific evidence on the effectiveness and fetal safety of Diclegis(®)/Diclectin(®) for the treatment of NVP to justify its use as first-line treatment for NVP. [ncbi.nlm.nih.gov]
Entire Body System
- Weight Loss
Hyperemesis gravidarum is persistent, severe pregnancy-induced vomiting that causes significant dehydration, often with electrolyte abnormalities, ketosis, and weight loss. [msdmanuals.com]
Hyperemesis gravidarum is less common but is severe, leading to dehydration, ketosis, and weight loss. Consider nonobstetric causes of nausea and vomiting. [merckmanuals.com]
Indications for referral to secondary care include: [ 2 ] Continued nausea and vomiting associated with ketonuria or weight loss (>5% body weight), despite oral anti-emetics. [patient.info]
- Malnutrition
There are many options for treating this condition, which can cause dehydration, weight loss and malnutrition. If you’re severely dehydrated, you might need to be given IV fluids, and you might be given pregnancy-safe antinausea medicine. [thebump.com]
But instead, women can show signs of malnutrition and starvation, she said. [livescience.com]
In very rare instances jaundice may result - thought to be due to severe protein and vitamin malnutrition. The cause of the vomiting is primarily physiological but psychological factors may affect the apparent severity. [gpnotebook.co.uk]
Less common but severe complications of hyperemesis gravidarum include: Ruptured esophagus from forceful vomiting Collapsed lung Liver disease Blindness Brain swelling from malnutrition Kidney failure Blood clots Seizures Coma Death [everydayhealth.com]
Malnutrition, electrolyte imbalance, and the need for bed rest can weaken your muscles. Your saliva. You may make too much. Swallowing it may make nausea even worse. Your doctor will need to help you manage this. [webmd.com]
- Weight Gain
They had higher rates of preterm delivery, pregnancy-induced hypertension and low birth weight CONCLUSION: NVP and subsequent poor weight gain may be associated with adverse pregnancy outcomes. [ncbi.nlm.nih.gov]
Vomiting is one of the main signs of preeclampsia and is often accompanied by headaches, visual changes, sudden weight gain, bloating, and high blood pressure. [pregnancy.lovetoknow.com]
gain Hospitalization is usually needed for hyperemesis gravidarum. [stanfordchildrens.org]
HG can lead to dehydration and poor weight gain during pregnancy. There’s no known way to prevent morning sickness or HG, but there are ways to manage the symptoms. HG usually starts during the first trimester of pregnancy. [healthline.com]
Severe vomiting is harmful because it leads to dehydration and poor weight gain during pregnancy. Rarely, a woman may have bleeding in her esophagus or other serious problems from constant vomiting. [medlineplus.gov]
- First Trimester Pregnancy
Although it is usually deemed a first trimester symptom, many women suffer for longer than 12 weeks, some for the duration of pregnancy. [rcm.org.uk]
Background Nausea and vomiting in pregnancy (NVP) is a common and debilitating condition that affects many women in the first trimester of pregnancy. [racgp.org.au]
An estimated 60% of cases resolve by the end of the first trimester, and 87% resolve by 20 weeks' gestation. 13 Women who have atypical presentations (e.g., onset of symptoms after nine weeks' gestation, symptoms beyond the first trimester, severe symptoms [aafp.org]
View Article PubMed Google Scholar Brandes JM: First-trimester nausea and vomiting as related to outcome of pregnancy. Obstet Gynecol. 1967, 30: 427-431. [bmcmedicine.biomedcentral.com]
- Trisomy 21
You can identify HG through: a dry mouth faster heart beat less urination extreme thirst low blood pressure excessive weight loss HG could indicate fetal abnormalities such as triploidy, trisomy 21, and hydrops fetalis, and nulliparity (5). [momjunction.com]
Nausea and vomiting in pregnancy [published correction appears in N Engl J Med. 2010;363(21):2078]. N Engl J Med. 2010;363(16):1544–1550. 7. Golberg D, Szilagyi A, Graves L. [aafp.org]
Gastrointestinal
- Vomiting
Let it cool down and enjoy the clove and honey tea to avoid vomiting sensation. Basic Question about Nausea and Vomiting During pregnancy Q1 What causes Nausea and vomiting in Pregnancy? That is a common question with no exact answer. [homeremediesblog.com]
BACKGROUND: Early medical management of nausea and vomiting during pregnancy is desirable but less than optimal. [ncbi.nlm.nih.gov]
- Nausea
Gastric dysrhythmias are disturbances of gastric pacesetter potential patterns that are present during the nausea of motion sickness, drug-induced nausea, in patients with diabetic gastropathy, and women with nausea of pregnancy. [ncbi.nlm.nih.gov]
Basic Question about Nausea and Vomiting During pregnancy Q1 What causes Nausea and vomiting in Pregnancy? That is a common question with no exact answer. It means that there is no definite reason why nausea and vomiting happen. [homeremediesblog.com]
- Morning Sickness
Abstract Nausea and vomiting of pregnancy, "morning sickness", is a common contemporary complaint. Many pregnant patients note alterations in smell and taste which can precipitate "morning sickness", symptoms that characterize early gestation. [ncbi.nlm.nih.gov]
What is morning sickness? Nobody knows why the first sign of pregnancy for many mums-to-be is an early morning dash to the bathroom. [babycenter.com.my]
Morning Sickness Pregnancy Symptoms Quiz [babymed.com]
- Abdominal Pain
In pregnant women with abdominal pain, nausea, and vomiting, standard gastrointestinal diseases such as gastroesophageal reflux, peptic ulcers, and cholecystitis must be considered. [ncbi.nlm.nih.gov]
- Eating Frequently
RESULTS: The most frequently recommended treatments for a patient with moderate to severe nausea with occasional vomiting were: eat frequent, small meals (93%); snack on soda crackers (68.5%); and take vitamin B6 plus doxylamine (67.1%). [ncbi.nlm.nih.gov]
If she can tolerate fluids, she can begin eating frequent, small portions of bland foods. The size of the portions is increased as she can tolerate more food. If symptoms recur, the treatment is repeated. [merckmanuals.com]
The following can also help: consuming a bland diet eating frequent small meals drinking plenty of fluids when not feeling nauseated avoiding spicy and fatty foods eating high-protein snacks avoiding sensory stimuli that can act as triggers Additionally [kidshealth.org]
Pregnancy-induced vomiting may be relieved by drinking or eating frequently (5 or 6 small meals/day), but only bland foods (eg, crackers, soft drinks, BRAT diet [bananas, rice, applesauce, dry toast]) should be eaten. Eating before rising may help. [msdmanuals.com]
Liver, Gall & Pancreas
- Jaundice
If it does, it may severely damage the liver, causing jaundice and degeneration of liver tissue. If hyperemesis gravidarum severely damages the liver or causes severe dehydration, women can become confused. [merckmanuals.com]
In very rare instances jaundice may result - thought to be due to severe protein and vitamin malnutrition. The cause of the vomiting is primarily physiological but psychological factors may affect the apparent severity. [gpnotebook.co.uk]
Liver damage and jaundice (yellowing of the skin, eyes, and mucous membranes) may occur with severe hyperemesis gravidarum. Thiamine deficiency may occur. Excessive weight loss and poor nutrition in the mother may affect fetal growth. [stanfordchildrens.org]
[…] nutrients pyridoxine and zinc Hyperemesis gravidarum may lead to the following symptoms and conditions: Severe nausea and vomiting Dizziness, lightheadedness, and fainting Increased salivation Anemia Headaches Confusion Yellowing of the skin and eyes (jaundice [everydayhealth.com]
AFLP patients more often present with malaise, nausea and vomiting, abdominal pain, and jaundice. Jaundice is uncommon in HELLP. [emdocs.net]
Skin
- Ulcer
In pregnant women with abdominal pain, nausea, and vomiting, standard gastrointestinal diseases such as gastroesophageal reflux, peptic ulcers, and cholecystitis must be considered. [ncbi.nlm.nih.gov]
Treatments may include drugs such as dronabinol, granisetron, lorazepam, prochlorperazine, and steroids, among others. gastric emesis Vomiting present in gastric ulcer, gastric carcinoma, acute gastritis, chronic gastritis, hyperacidity and hypersecretion [medical-dictionary.thefreedictionary.com]
Gastrointestinal: Helicobacter pylori bacteria that live in the intestinal tract may cause the development of peptic ulcer disease. [emedicinehealth.com]
Eyes
- Retinal Hemorrhage
hemorrhage, Mallory-Weiss syndrome, pneumothorax). 17, 18 Treatment Treatment should be directed toward reducing symptoms while posing the least amount of risk to the fetus and mother. [aafp.org]
Neurologic
- Dizziness
Ketosis can cause fatigue, bad breath, dizziness, and other symptoms. Women with hyperemesis gravidarum often become so dehydrated that the balance of electrolytes, needed to keep the body functioning normally, is upset. [msdmanuals.com]
You may be too weak or dizzy to stand. You may pass out. Call your doctor if: You have symptoms of moderate dehydration. Vomiting is so severe that you are not able to drink fluids. Your vomiting has not gotten better with home treatment. [healthlinkbc.ca]
headache, fatigue — Diphenhydramine (Benadryl) 25 to 50 mg every eight hours Drowsiness, dizziness, headache, fatigue — Hydroxyzine (Vistaril) 50 mg every four to six hours Drowsiness, dizziness, headache, fatigue — Meclizine (Antivert) 25 mg every [aafp.org]
A woman might have hyperemesis gravidarum if she is pregnant and she vomits: More than three to four times per day So much that she loses more than 10 pounds So much that she feels dizzy and lightheaded So much that she is becoming dehydrated What are [my.clevelandclinic.org]
- Vertigo
The effect of periconceptional multivitamin-mineral supplementation on vertigo, nausea and vomiting in the first trimester of pregnancy. Arch Gynecol Obstet 1992; 251:181. Emelianova S, Mazzotta P, Einarson A, Koren G. [alessandragraziottin.it]
The effect of periconceptional multivitamin-mineral supplementation on vertigo, nausea and vomiting in the first trimester of pregnancy. Arch Gynecol Obstet 1992;251:181-5. Back to home [nvp-volumes.org]
The effect of periconceptional multivitamin-mineral supplementation on vertigo, nausea and vomiting in the first trimester of pregnancy. Arch Gynecol Obstet. 1992. 251(4):181-5. [Medline]. Czeizel AE, Vargha P. [emedicine.medscape.com]
Workup
However, an elevated free thyroxine may suggest that overt hyperthyroidism is present, thus necessitating further workup and treatment. [3] Urine culture: This may be indicated because urinary tract infection is common in pregnancy and can be associated [emedicine.medscape.com]
Urine
- Albuminuria
Albuminuria. Ketonuria. www.freelivedoctor.com 7. Diagnosis Symptoms: >The patient cannot retain anything in her stomach, vomiting occurs through the day and night even without eating. >Thirst, constipation and oliguria. [de.slideshare.net]
Serum
- Hyponatremia
Serum electrolyte and acid-base abnormalities may include hypochloremic alkylosis, hypokalemia, and hyponatremia [ 7 ]. [karger.com]
- Hypoglycemia
Again, hypoglycemia, elevated bilirubin, hypofibrinogenemia, ascites, and encephalopathy are more common in AFLP. 1,4 Gestational trophoblastic disease (GTD) GTD can be divided into hydatidiform moles or non-molar trophoblastic neoplasms. [emdocs.net]
Microbiology
- Helicobacter Pylori
Recent research has implicated Helicobacter pylori as one possible cause. Nausea and vomiting of pregnancy is generally a mild, self-limited condition that may be controlled with conservative measures. [ncbi.nlm.nih.gov]
Helicobacter pylori infection Chronic infection with helicobacter pylori may also cause HG [ 16 – 22 ]. [bmcmedicine.biomedcentral.com]
Role of Helicobacter pylori in the pathogenesis of hyperemesis gravidarum. Arch Gynecol Obstet 2011; 284:843. Matthews A, Haas DM, O'Mathúna DP, et al. Interventions for nausea and vomiting in early pregnancy. [alessandragraziottin.it]
Hyperemesis gravidarum associated with Helicobacter pylori seropositivity. Obstet Gynecol. 1998 Apr. 91(4):615-7. [Medline]. Fukada Y, Ohta S, Mizuno K. Rhabdomyolysis secondary to hyperemesis gravidarum. [emedicine.medscape.com]
Treatment
Despite increased symptom severity in the treatment group, the combination regimen was efficacious: 20/29 (69%) vs. 18/25 (72%) in the treatment vs. control women respectively (P = 0.65). There were no congenital anomalies in the treatment group. [ncbi.nlm.nih.gov]
Prognosis
Prognosis [ 1 ] Most cases are self-limiting and settle without complication as pregnancy progresses. However, nausea and vomiting may cause significant psychosocial difficulties, time off work and a restriction of domestic and leisure activities. [patient.info]
Pregnancy outcome and prognosis In most cases, nausea and vomiting during pregnancy is self limiting and is usually resolved by around 20 weeks gestation [ 13 ]. [bmcmedicine.biomedcentral.com]
Etiology
Gestational hormones There is no proven role for gestational hormones in the etiology of NVP. [nvp-volumes.org]
The study identifies a number of factors that are related to the occurrence of NVP and that may give hints on the etiology of the condition. [ncbi.nlm.nih.gov]
Psychological factors in the etiology and treatment of severe nausea and vomiting in pregnancy. Am J Obstet Gynecol 2002; 186:S210. Czeizel AE, Dudas I, Fritz G, et al. [alessandragraziottin.it]
To help healthcare providers and their pregnant patients reach these goals, this article details the scope, etiology, impact, assessment, and management of NVP. [npwomenshealthcare.com]
Etiology unknown. Appear in both sexes; onset in early infancy. Autosomal recessive inheritance is probable. First described by Brandt in 1936. The term Akrodermatitis enteropathica was introduced by Danbolt and Closs in 1942. Bibliography T. E. [whonamedit.com]
Epidemiology
This article reviews the epidemiology, pathology, diagnosis, outcomes, and treatment of NVP and HG. Copyright © 2011 Elsevier Inc. All rights reserved. [ncbi.nlm.nih.gov]
Pathophysiology
The pathophysiology remains unclear, however, the cause of nausea and vomiting in pregnancy is thought to be related to the high levels of beta-hCG and estrogen, as well as other hormonal, immunologic, and psychological contributors. return to top Signs [sharinginhealth.ca]
The pathophysiology of nausea and vomiting during early pregnancy is unknown, although metabolic, endocrine, gastrointestinal, and psychologic factors probably all play a role. [msdmanuals.com]
Aetiology and Pathophysiology Nausea and vomiting of pregnancy (NVP) normally starts between 4 and 7 weeks’ gestation. It reaches a peak in the 9 th week, and settles by week 20 in 90% of women. [teachmeobgyn.com]
[ edit ] Hormone changes [ edit ] Pathophysiology of vomiting in pregnancy An increase in the circulating level of the hormone estrogen. [10] However, there is no consistent evidence of differences in estrogen levels and levels of bilirubin between women [en.wikipedia.org]
Prevention
[…] provides an update on the management of NVP, including pharmacological and non pharmacological approaches Due to a high rate of recurrent symptoms, it is important for women to receive early treatment to reduce the severity of symptoms with the aim of preventing [ncbi.nlm.nih.gov]
Snack on Crackers Snacking on crackers in the morning just after waking up is a great way to stop nausea and prevent vomiting during pregnancy. [top10homeremedies.com]