Objective The objective of this study was to determine the impact of nausea and vomiting of pregnancy (NVP) and other determinants on generic and NVP-specific health-related quality of life (QOL) in the first trimester of pregnancy.Design Prospective study.Setting Centre Hospitalier Universitaire (CHU) Sainte-Justine or René-Laennec clinics, Montreal, Quebec, Canada.Population Pregnant women attending the clinics for their prenatal care from 2004 to 2006. Women were eligible if they were ‡18 years of age and £16 weeks of gestation at the time of their first prenatal visit.Methods After their first prenatal visit, women were asked to fill out a questionnaire covering maternal characteristics, presence and severity of NVP, and health-related QOL.Main outcome measures QOL was measured by the generic 12-item Short Form Health Survey v.1 (SF-12) and the NVP-specific Quality of Life for Nausea and Vomiting during Pregnancy.Results Of the 367 pregnant women included in the study, 78.5% of women reported NVP in the first trimester of pregnancy. Multivariable linear models showed that presence of NVP in the first trimester of pregnancy was significantly associated with a lower physical component summary scale (P < 0.0001) and mental component summary scale (P = 0.0066) of the SF-12 scores. More severe NVP (moderate versus mild: P = 0.0002; severe versus mild: P = 0.0177 as measured by the validated modified Pregnancy-Unique Quantification of Emesis and Nausea index), intensity of nausea symptoms reported on a visual analogue scale (P < 0.0001), and nonpharmacological methods used to ease NVP symptoms in the first trimester of pregnancy (P = 0.0059) were significantly associated with poorer NVPspecific QOL among women suffering from NVP.Conclusion These findings show that presence and severity of NVP have a negative impact on health-related QOL, which emphasises the importance of an optimal management of NVP.

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The placental transfer from maternal to fetal circulation of ritodrine, a tocolytic agent used in obstetrics and of a structurally related physiologic catecholamine, norepinephrine was studied in vitro using dual perfusion of isolated human placental lobules. The clearances of ritodrine and norepinephrine represent 34 and 24% respectively of tritiated water clearance taken as reference. The relatively low ritodrine clearance may be explained by its small molecular weight and hydrosoluble nature, but not that of norepinephrine. For the latter, a strong membrane limitation and efficient placental catabolism may be implicated. We conclude that some of the fetal effects of maternal infusion of these amines are the result of the method in which the drug is transferred.

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The antiepileptic drug vigabatrin (VGB) is a selective irreversible inhibitor of GABA‐transaminase. It is administered as a racemic R(−), S(+) mixture, but the pharmacological activity of vigabatrin resides in the S(+) enantiomer and the R(−) enantiomer is inactive. The pharmacokinetic parameters of the two enantiomers have been studied after administration of a single oral 125 mg dose of the racemate to six neonates. The mean values of Cmax and AUC of the S(+) enantiomer were significantly lower (Cmax : 14.0±4.3 mg l−1; AUC: 143±44 mg l−1 h) than those of the R(−) enantiomer (Cmax: 34.1±9.5 mg l−1; AUC: 231±88 mg l−1 h), whereas no significant difference in the time to reach Cmax (S(+): 2.1±1.1 h; R(−): 2.2±1 h) was observed between the two enantiomers. During chronic administration (125 mg twice daily over 4 days), there was no evidence of accumulation of either enantiomer.