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
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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]
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Noncompliance
One woman stopped participation during the IV infusion while data were not available in 2 additional women after patch placement due to noncompliance. [ncbi.nlm.nih.gov]
We chose a study period of 4 days because a previous study 6 showed that the effect of ginger was evident within a few days of treatment and too long a period would result only in a higher rate of subject noncompliance and loss to follow-up. [journals.lww.com]
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Pseudotumor
Pyelonephritis Uncommon causes Acute fatty liver of pregnancy Addison disease Appendicitis Central nervous system tumors Degenerating uterine leiomyoma Diabetic ketoacidosis Hypercalcemia Intestinal obstruction Meniere disease Ovarian torsion Porphyria Pseudotumor [aafp.org]
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Euthyroid
[…] unclear as to whether the patient has thyrotoxicosis that is causing nausea and vomiting, or whether hCG, especially asialo-hCG, is stimulating the thyroid directly. 15 - 17 Anti-thyroid medication should not be administered if the patient is clinically euthyroid [nvp-volumes.org]
Gastrointestinal
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Vomiting
BACKGROUND: Early medical management of nausea and vomiting during pregnancy is desirable but less than optimal. [ncbi.nlm.nih.gov]
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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]
Liver, Gall & Pancreas
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Jaundice
AFLP patients more often present with malaise, nausea and vomiting, abdominal pain, and jaundice. Jaundice is uncommon in HELLP. [emdocs.net]
Yellow skin (jaundice). Severe weakness or feeling faint. Blood in your vomit. Repeated, unstoppable vomiting. [patient.info]
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]
Eyes
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Retinal Hemorrhage
esophageal rupture, retinal 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
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Extrapyramidal Symptoms
5 mg three times daily Extrapyramidal symptoms Sedation Cyclizine 50 mg three times daily Sedation Promethazine 25 mg at bedtime, increased to maximum 100 mg daily in divided doses Extrapyramidal symptoms Sedation Ondansetron (hyperemesis gravidarum) [bpac.org.nz]
symptoms, hypotension Available as buccal tablet Scopolamine 1-mg patch behind ear every three days Drowsiness, dry mouth, urinary retention May cause limb and trunk deformities if used in first trimester Trimethobenzamide (Tigan) 300 mg every six to [aafp.org]
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]
Serum
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Hyponatremia
Serum electrolyte and acid-base abnormalities may include hypochloremic alkylosis, hypokalemia, and hyponatremia [ 7 ]. [karger.com]
Treatment
Consequently, treatment of NVP and HG can be difficult, as neither the optimal targets for treatment nor the full effects of potential treatments on the developing fetus are known. [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]
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]
It is important to determine the etiology of the patient's vomiting, taking into account the frequency, severity, and onset (e.g. presentations of vomiting later along in the pregnancy) and associated symptoms to create a differential diagnosis. [sharinginhealth.ca]
Etiology Since our earlier review of this topic in 2000, we note limited advancement in the understanding of the precise etiology of hyperemesis gravidarum [ 11 ]. [karger.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]
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]
The pathophysiology of nausea and vomiting in early pregnancy and hyperemesis gravidarum is poorly understood. Various hormonal, biochemical, mechanical and psychological factors have been implicated. [academic.oup.com]
Another barrier to the effective management of NVP in Australia is the lack of an approved pyridoxine/doxylamine combination – a therapy that is considered first-line management in most other countries.1 Significance of NVP The exact pathophysiology underlying [racgp.org.au]
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]