Hyperemesis gravidarum new evidence
DOI:
https://doi.org/10.47187/cssn.Vol14.IssEd.Esp.226Keywords:
hyperemesis gravidarum, vomiting, pregnancyAbstract
Introduction: Hyperemesis gravidarum is a pregnancy disorder characterized by severe and persistent nausea and vomiting, which can lead to dehydration, electrolyte imbalances, significant weight loss, and have a negative impact on maternal and fetal health. Objective: To provide an updated comprehensive synthesis of the available literature for proper management. Methodology: The PICO question "In pregnant patients with hyperemesis gravidarum (P), what is the efficacy of different treatments (I) compared to placebo or standard treatment (C) in reducing symptoms and improving pregnancy outcomes (O)?" established to guide the literature search. Specialized databases such as PubMed, Scopus, UpToDate, and DynaMed were used. Results: A total of 3640 articles were obtained, and 3605 were excluded based on the inclusion criteria. Thirty-five articles were used for this research. Discussion: The diagnosis is based on clinical symptoms, such as severe vomiting leading to dehydration and weight loss exceeding 5% of pre-pregnancy body weight. The management of this condition involves dietary changes, nutritional therapy, medications, and, in severe cases, hospitalization. Conclusions: The management of hyperemesis gravidarum requires a combination of strategies, including rehydration, correction of nutritional and electrolyte imbalances, symptom control with medications, and emotional support, as well.
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References
Smith J, Fox K, Clark S. Nausea and vomiting of pregnancy: Clinical findings and evaluation [Internet]. UpToDate. 2022 [cited 2023 Apr 6]. Available from: https://www.uptodate.com/contents/nausea-and-vomiting-of-pregnancy-clinical-findings-and-evaluation/print?search=hiperemesis gravídica&source=search_result&selectedTitle=2~146&usage_type=default&display_rank=2
Smith J, Fox K, Clark S. Nausea and vomiting of pregnancy: Treatment and outcome [Internet]. UpToDate. 2022 [cited 2023 Apr 6]. Available from: https://www.uptodate.com/contents/nausea-and-vomiting-of-pregnancy-treatment-and-outcome/print?search=hiperemesis gravídica&source=search_result&selectedTitle=1~146&usage_type=default&display_rank=1
DynaMed. Nausea and Vomiting in Pregnancy [Internet]. EBSCO Information Services. 2023 [cited 2023 Apr 6]. Available from: https://www.dynamed.com/condition/nausea-and-vomiting-in-pregnancy
Bianco A. Maternal adaptations to pregnancy: Gastrointestinal tract [Internet]. UpToDate. 2022 [cited 2023 Apr 26]. Available from: https://www.uptodate.com/contents/maternal-adaptations-to-pregnancy-gastrointestinal-tract/print?search=Hyperemesis Gravidarum&source=search_result&selectedTitle=8~147&usage_type=default&display_rank=8
Longstreth G. Approach to the adult with nausea and vomiting [Internet]. UpToDate. 2022 [cited 2023 Apr 26]. Available from: https://www.uptodate.com/contents/approach-to-the-adult-with-nausea-and-vomiting/print?search=Hyperemesis Gravidarum&source=search_result&selectedTitle=4~147&usage_type=default&display_rank=4
Ramin SM. Nausea and Vomiting of Pregnancy. ACOG Practice Bulletin. Clinical Management Guidelines for Obstetrician–Gynecologists [Internet]. The American College of Obstetricians and Gynecologists. 2018 [cited 2023 Apr 26]. Available from: https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2018/01/nausea-and-vomiting-of-pregnancy
Boutib A, Chergaoui S, Marfak A, Hilali A, Youlyouz-Marfak I. Quality of Life During Pregnancy from 2011 to 2021: Systematic Review. Int J Womens Health [Internet]. 2022 [cited 2023 Apr 26];14:975. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9356752/
Wong ZY, Ou KQ, Prasad A, Say WX, Nalliah S. Clinical practice guidelines for the management of hyperemesis gravidarum A systematic review and quality appraisal with AGREE II. Aust J Gen Pract [Internet]. 2022 Oct 1 [cited 2023 Apr 26];51(10):758–65. Available from: https://www1.racgp.org.au/ajgp/2022/october/guidelines-for-the-management-of-hyperemesis-gravi/
Ozgunay SE, Dincgez B, Karasu D, Ozgen G, Taymur I, Eminoglu S, et al. Adjuvant Hypnotherapy for Hyperemesis Gravidarum: A Randomized Pilot Study. Int J Clin Exp Hypn [Internet]. 2022 [cited 2023 Apr 26];70(3):277–85. Available from: https://www.scopus.com/record/display.uri?eid=2-s2.0-85134620714&origin=resultslist&sort=plf-f&src=s&sid=b100e2718c9516658e5599b8efcbc619&sot=b&sdt=cl&cluster=scosubjabbr%2C%22HEAL%22%2Ct&s=TITLE-ABS-KEY%28%22hyperemesis+gravidarum%22+OR+%22hyperemesis%22
Moradiha F, Farahmandrad S, Gholami H. Comparison of the effectiveness of ondansetron versus metoclopramide in hyperemesis gravidarum: A randomized clinical trial. Front Emerg Med. 2022 Feb 1;6(1).
Dynamed. Treatments of Common Health Concerns in Pregnancy [Internet]. EBSCO Information Services. 2023 [cited 2023 Apr 26]. Available from: https://www.dynamed.com/management/treatments-of-common-health-concerns-in-pregnancy#GUID-DE33F504-953E-4176-8046-789EE66DDFAF
Nijsten K, Van Der Minnen L, Wiegers HMG, Koot MH, Middeldorp S, Roseboom TJ, et al. Hyperemesis gravidarum and vitamin K deficiency: a systematic review. Br J Nutr [Internet]. 2022 Jul 7 [cited 2023 Apr 26];128(1):30. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9279941/
Albazee E, Almahmoud L, Al-Rshoud F, Sallam D, Albzea W, Alenezi R, et al. Ondansetron versus metoclopramide for managing hyperemesis gravidarum: A systematic review and meta-analysis of randomized controlled trials. Turkish J Obstet Gynecol [Internet]. 2022 Jun 27 [cited 2023 Apr 26];19(2):162. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9249360/
Yan R, Zhan J, Liu G, Li C, Cai P, Chen Y, et al. A comparison of the efficacy and safety of traditional Chinese medicine external treatment for the hyperemesis gravidarum: A protocol for systematic review and network meta-analysis. Medicine (Baltimore) [Internet]. 2020 Nov 11 [cited 2023 Apr 26];99(45):e23019. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7647590/
Nijsten K, Jansen LAW, Limpens J, Finken MJJ, Koot MH, Grooten IJ, et al. Long-term health outcomes of children born to mothers with hyperemesis gravidarum: a systematic review and meta-analysis. Am J Obstet Gynecol [Internet]. 2022 Sep 1 [cited 2023 Apr 26];227(3):414-429.e17. Available from: https://reader.elsevier.com/reader/sd/pii/S0002937822002496?token=9533C98711BC09AEB7D01E3B1575958A22260BEBF45BB7E5E1BCFBA3834D4740277141CEDE36C7C9533422F61BBB73DC&originRegion=us-east-1&originCreation=20230426172222
Farshbaf-Khalili A, Salehi-Pourmehr H, Najafipour F, Alamdari NM, Pourzeinali S, Ainehchi N. Is hyperemesis gravidarum associated with transient hyperthyroidism? A systematic review and meta-analysis. Taiwan J Obstet Gynecol [Internet]. 2023 Mar 1 [cited 2023 Apr 26];62(2):205–25. Available from: https://www.sciencedirect.com/science/article/pii/S1028455923000207?via%3Dihub
Das Neves M de C, Teixeira AA, Garcia FM, Rennó J, da Silva AG, Cantilino A, et al. Eating disorders are associated with adverse obstetric and perinatal outcomes: a systematic review. Brazilian J Psychiatry [Internet]. 2022 [cited 2023 Apr 26];44(2):201. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9041959/
Tan GN, Tan PC, Hong JGS, Kartik B, Omar SZ. Rating of four different foods in women with hyperemesis gravidarum: a randomised controlled trial. BMJ Open [Internet]. 2021 May 13 [cited 2023 Apr 26];11(5):46528. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8126296/
Lu H, Zheng C, Zhong Y, Cheng L, Zhou Y. Effectiveness of Acupuncture in the Treatment of Hyperemesis Gravidarum: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med [Internet]. 2021 [cited 2023 Apr 26];2021. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8337134/
Jansen LAW, Nijsten K, Limpens J, van Eekelen R, Koot MH, Grooten IJ, et al. Perinatal outcomes of infants born to mothers with hyperemesis gravidarum: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol [Internet]. 2023 May [cited 2023 Apr 26];284:30–51. Available from: https://reader.elsevier.com/reader/sd/pii/S0301211523000830?
token=FA6C90084916811D153B832967210670306A66DC36055D87D192B895D6D34E5DB93A6A9AFB94E54CDFD420A046A30E5D&originRegion=us-east-1&originCreation=20230426174125
Varela P, Deltsidou A. Hyperemesis gravidarum and neonatal outcomes: A systematic review of observational studies. Taiwan J Obstet Gynecol [Internet]. 2021 May 1 [cited 2023 Apr 26];60(3):422–32. Available from: https://reader.elsevier.com/reader/sd/pii/S1028455921000589?token=4D9A1F2B8A2244FB6B3AA03776796E5C8EE6DCAA5BD66EA7F95B793A33C0F23960452F1BF4C5EC868D31D2473C24A752&originRegion=us-east-1&originCreation=20230426172709
Kloter E, Gerstenberg G, Berenyi T, Gollmer B, Flüger C, Klein U, et al. Treatment of hyperemesis gravidarum with anthroposophic complex therapy in 3 case reports. Complement Ther Med [Internet]. 2019 Jun 1 [cited 2023 Apr 26];44:14–7. Available from: https://www.scopus.com/record/display.uri?eid=2-s2.0-85063615552&origin=resultslist&sort=plf-f&src=s&sid=b100e2718c9516658e5599b8efcbc619&sot=b&sdt=cl&cluster=scosubjabbr%2C%22HEAL%22%2Ct&s=TITLE-ABS-KEY%28%22hyperemesis+gravidarum%22+OR+%22hyperemesis%22
Galletta MAK, Tess VLC, Pasotti IM, Pelegrini LF, Ribeiro Rocha NK, Testa CB, et al. Use of Mirtazapine and Olanzapine in the Treatment of Refractory Hyperemesis Gravidarum: A Case Report and Systematic Review. Case Rep Obstet Gynecol [Internet]. 2022 [cited 2023 Apr 26];2022. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9467790/
Jansen LAW, Koot MH, van’t Hooft J, Dean CR, Bossuyt PMM, Ganzevoort W, et al. The windsor definition for hyperemesis gravidarum: A multistakeholder international consensus definition. Eur J Obstet Gynecol Reprod Biol [Internet]. 2021 Nov 1 [cited 2023 May 7];266:15–22. Available from: https://reader.elsevier.com/reader/sd/pii/S0301211521004486?token=CDF6FEB128B91B79844B84CF42F2FD46EE1E12C1965A7D74AABC6C8FFFFD6812960FCBAD9BB4907CB38BC18D480589CC&originRegion=us-east-1&originCreation=20230507125918
Varlas VN, Bohîlțea R, Gheorghe G, Bostan G, Angelescu GA, Penes ON, et al. State of the art in hepatic dysfunction in pregnancy. Healthc [Internet]. 2021 Nov 1 [cited 2023 Apr 26];9(11). Available from: https://www.scopus.com/record/display.uri?eid=2-s2.0-85118726303&origin=resultslist&sort=plf-f&src=s&sid=b100e2718c9516658e5599b8efcbc619&sot=b&sdt=cl&cluster=scosubjabbr%2C%22HEAL%22%2Ct&s=TITLE-ABS-KEY%28%22hyperemesis+gravidarum%22+OR+%22hyperemesis%22
Dean CR, Bruin CM, O’Hara ME, Roseboom TJ, Leeflang MM, Spijker R, et al. The chance of recurrence of hyperemesis gravidarum: A systematic review. Eur J Obstet Gynecol Reprod Biol X [Internet]. 2020 Jan 1 [cited 2023 Apr 26];5. Available from: https://reader.elsevier.com/reader/sd/pii/S2590161319301383?token=00E3D852C1DDB14ED70755FC14961F5123A5CDB9E8500C99B6F29AD095C301E630740E7FD344F1F838AEEF0BB7B70501&originRegion=us-east-1&originCreation=20230426175200
Crichton M, Davidson AR, Innerarity C, Marx W, Lohning A, Isenring E, et al. Orally consumed ginger and human health: an umbrella review. Am J Clin Nutr [Internet]. 2022 Jun 1 [cited 2023 May 8];115(6):1511. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9170469/
Hu Y, Amoah AN, Zhang H, Fu R, Qiu Y, Cao Y, et al. Effect of ginger in the treatment of nausea and vomiting compared with vitamin B6 and placebo during pregnancy: a meta-analysis. J Matern Fetal Neonatal Med [Internet]. 2022 [cited 2023 May 8];35(1):187–96. Available from: https://pubmed.ncbi.nlm.nih.gov/31937153/
Vitamin B6 - Health Professional Fact Sheet [Internet]. National Institutes of Health. 2023 [cited 2023 May 9]. Available from: https://ods.od.nih.gov/factsheets/VitaminB6-HealthProfessional/
Mohd Nafiah NA, Chieng WK, Zainuddin AA, Chew KT, Kalok A, Abu MA, et al. Effect of Acupressure at P6 on Nausea and Vomiting in Women with Hyperemesis Gravidarum: A Randomized Controlled Trial. Int J Environ Res Public Health [Internet]. 2022 Sep 1 [cited 2023 Apr 26];19(17). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9518577/
Huybrechts KF, Hernández-Díaz S, Straub L, Gray KJ, Zhu Y, Patorno E, et al. Association of maternal first trimester ondansetron use with cardiac malformations and oral clefts in offspring. JAMA [Internet]. 2018 Dec 12 [cited 2023 May 10];320(23):2429. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6669077/
Parker SE, Van Bennekom C, Anderka M, Mitchell AA. Ondansetron for Treatment of Nausea and Vomiting of Pregnancy and the Risk of Specific Birth Defects. Obstet Gynecol [Internet]. 2018 [cited 2023 May 10];132(2):385–94. Available from: https://pubmed.ncbi.nlm.nih.gov/29995744/
Zambelli-Weiner A, Via C, Yuen M, Weiner DJ, Kirby RS. First trimester ondansetron exposure and risk of structural birth defects. Reprod Toxicol [Internet]. 2019 Jan 1 [cited 2023 May 10];83:14–20. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0890623818301230?via%3Dihub
Kahrilas P. Medical management of gastroesophageal reflux disease in adults [Internet]. UpToDate. 2022 [cited 2023 May 12]. Available from: https://www.uptodate.com/contents/medical-management-of-gastroesophageal-reflux-disease-in-adults/print?sectionName=PREGNANCY AND LACTATION&search=nauseas y vómitos en el embarazo&topicRef=6811&anchor=H18&source=see_link
Lamont JT. Treatment regimens for Helicobacter pylori in adults [Internet]. UpToDate. 2023 [cited 2023 May 13]. Available from: https://www.uptodate.com/contents/treatment-regimens-for-helicobacter-pylori-in-adults/print?sectionName=TREATMENT DURING PREGNANCY AND LACTATION&search=nauseas y vómitos en el embarazo&topicRef=6811&anchor=H3584616337&source=see_link
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