First trimester maternal serum PAPP‐A and free β‐HCG levels in hyperemesis gravidarum

Derbent, Aysel Uysal; Yanık, Filiz; Simavlı, Serap; Atasoy, Latife; Urun, Emel; Kuşçu, Ülkü Esra; Turhan, Nilgün Öztürk

doi:10.1002/pd.2715

Cited by 38 publications

(27 citation statements)

References 25 publications

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“…It still remains elusive whether such diff erences can be attributed to genetic factors related to ethnicity aff ecting outcomes in women with HG, or whether they could be a result of cultural diff erences aff ecting reporting of symptomology. HG is associated with elevated levels of PAPP-A and free β -hCG, as reported by a recent study in the Turkish population (Derbent et al 2011) and numerous other parameters have been analysed in the literature; among those are allergies suggesting a possible autoimmune component and a restrictive diet (Mullin et al 2012). Helicobacter pylori have also been proposed as a possible aetiological factor for HG but this remains controversial (Karadeniz et al 2006).…”

Section: Discussionmentioning

confidence: 89%

Pregnancy outcomes in severe hyperemesis gravidarum in a multi-ethnic population

Vlachodimitropoulou-Koumoutsea

Gosh

Manmatharajah

et al. 2013

Journal of Obstetrics and Gynaecology

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We evaluated pregnancy outcomes among women with hyperemesis gravidarum (HG) in a North London multi-ethnic population. A retrospective case-control study was performed on records of obstetric admissions during a 4-year period, at North Middlesex University Hospital in North London. A total of 208 women with HG were identified according to Fairweather's criteria occurring in the first 20 weeks of pregnancy, which is severe enough to require admission to hospital. The control study group consisted of 208 women without HG, matched for age, ethnicity and parity. Maternal characteristics as well as pregnancy outcomes were compared in the two groups. The incidence of a delivery of a small-for-gestational-age (SGA) neonate below the 10th per centile was significantly higher in the HG group compared with unaffected pregnancies (8.7% vs 16.8%, p = 0.01). Hyperemesis gravidarum in a multi-ethnic population in North London is associated with SGA neonates.

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Section: Discussionmentioning

confidence: 89%

Pregnancy outcomes in severe hyperemesis gravidarum in a multi-ethnic population

Vlachodimitropoulou-Koumoutsea

Gosh

Manmatharajah

et al. 2013

Journal of Obstetrics and Gynaecology

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“…One observational study demonstrated that women with HG were more likely to have higher levels of pregnancy-associated plasma protein A (PAPP-A) and free human chorionic gonadotropin (hCG) in the first trimester compared with controls 34. Maternal serum concentrations of hCG peak during the first trimester, when HG symptoms are often at their worst 35.…”

Section: Risk Factors For Hgmentioning

confidence: 99%

“…Similarly, symptoms of HG are often more severe in multiple pregnancies and molar pregnancies, which are conditions associated with excessively high hCG levels. However, conflicting reports exist,34–36 and therefore a causal association between HG and hCG has not been established 36. Infection with Helicobacter pylori may play a role in the development of HG in some women.…”

Section: Risk Factors For Hgmentioning

confidence: 99%

Hyperemesis gravidarum: current perspectives

McCarthy¹,

Lutomski²,

Greene³

2014

IJWH

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“…Belluomini and colleagues 62 used the RINVR as a combined measure of change in nausea, vomiting and retching between the pre-treatment period (mean of days 1-3) and the post-treatment period (mean of days [5][6][7]. The study found a significant reduction in combined scores for both groups (intervention from 12.64 ± 5.7 to 8.69 ± 5.0; p ≤ 0.001; placebo from 11.47 ± 4.9 to 10.03 ± 4.6; p = 0.019).…”

Section: Rhodes Index Of Nausea Vomiting and Retchingmentioning

confidence: 99%

“…In the last 24 hours, for how long have you felt nauseated or sick at your stomach, Not at all ( 1 ) 1 hour or less ( 2 ) 2-3 hours Median length of stay in days: (1) (1) 8 ( , (2) 8. [5][6][7][8][9], (3) 7 (IQR 6-9), (4) 7 (IQR 4-9); comparator (1) 10 (IQR 7-13), (2)(3)(4)(5)(6)(7)(8)(9)(10)(11), (3) 7 ( , (4) (1) 9. [5][6][7][8][9][10][11][12][13][14][15], (2) 9 (IQR 7-11), (3) 8. [5][6][7][8][9][10][11][12], (4) 7 ( ; comparator (1) 11 , (2) 9 ( , (3) 8 ( , (4) Spontaneous abortion: steroid n = 2 (4%), placebo n = 3 (6%); p = 0.6 l Gestational diabet...…”

Section: Motherisk Puqe-24 Scoring Systemmentioning

confidence: 99%

Treatments for hyperemesis gravidarum and nausea and vomiting in pregnancy: a systematic review and economic assessment

O’Donnell

McParlin

Robson

et al. 2016

Health Technol Assess

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BackgroundNausea and vomiting in pregnancy (NVP) affects up to 85% of all women during pregnancy, but for the majority self-management suffices. For the remainder, symptoms are more severe and the most severe form of NVP – hyperemesis gravidarum (HG) – affects 0.3–1.0% of pregnant women. There is no widely accepted point at which NVP becomes HG.ObjectivesThis study aimed to determine the relative clinical effectiveness and cost-effectiveness of treatments for NVP and HG.Data sourcesMEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, PsycINFO, Commonwealth Agricultural Bureaux (CAB) Abstracts, Latin American and Caribbean Health Sciences Literature, Allied and Complementary Medicine Database, British Nursing Index, Science Citation Index, Social Sciences Citation Index, Scopus, Conference Proceedings Index, NHS Economic Evaluation Database, Health Economic Evaluations Database, China National Knowledge Infrastructure, Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects were searched from inception to September 2014. References from studies and literature reviews identified were also examined.Obstetric Medicinewas hand-searched, as were websites of relevant organisations. Costs came from NHS sources.Review methodsA systematic review of randomised and non-randomised controlled trials (RCTs) for effectiveness, and population-based case series for adverse events and fetal outcomes. Treatments: vitamins B6 and B12, ginger, acupressure/acupuncture, hypnotherapy, antiemetics, dopamine antagonists, 5-hydroxytryptamine receptor antagonists, intravenous (i.v.) fluids, corticosteroids, enteral and parenteral feeding or other novel treatment. Two reviewers extracted data and quality assessed studies. Results were narratively synthesised; planned meta-analysis was not possible due to heterogeneity and incomplete reporting. A simple economic evaluation considered the implied values of treatments.ResultsSeventy-three studies (75 reports) met the inclusion criteria. For RCTs, 33 and 11 studies had a low and high risk of bias respectively. For the remainder (n = 20) it was unclear. The non-randomised studies (n = 9) were low quality. There were 33 separate comparators. The most common were acupressure versus placebo (n = 12); steroid versus usual treatment (n = 7); ginger versus placebo (n = 6); ginger versus vitamin B6 (n = 6); and vitamin B6 versus placebo (n = 4). There was evidence that ginger, antihistamines, metoclopramide (mild disease) and vitamin B6 (mild to severe disease) are better than placebo. Diclectin®[Duchesnay Inc.; doxylamine succinate (10 mg) plus pyridoxine hydrochloride (10 mg) slow release tablet] is more effective than placebo and ondansetron is more effective at reducing nausea than pyridoxine plus doxylamine. Diclectin before symptoms of NVP begin for women at high risk of severe NVP recurrence reduces risk of moderate/severe NVP compared with taking Diclectin once symptoms begin. Promethazine is as, and ondansetron is more, effective than metoclopramide for severe NVP/HG. I.v. fluids help correct dehydration and improve symptoms. Dextrose saline may be more effective at reducing nausea than normal saline. Transdermal clonidine patches may be effective for severe HG. Enteral feeding is effective but extreme method treatment for very severe symptoms. Day case management for moderate/severe symptoms is feasible, acceptable and as effective as inpatient care. For all other interventions and comparisons, evidence is unclear. The economic analysis was limited by lack of effectiveness data, but comparison of costs between treatments highlights the implications of different choices.LimitationsThe main limitations were the quantity and quality of the data available.ConclusionThere was evidence of some improvement in symptoms for some treatments, but these data may not be transferable across disease severities. Methodologically sound and larger trials of the main therapies considered within the UK NHS are needed.Study registrationThis study is registered as PROSPERO CRD42013006642.FundingThe National Institute for Health Research Health Technology Assessment programme.

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First trimester maternal serum PAPP‐A and free β‐HCG levels in hyperemesis gravidarum

Abstract: HG is associated with elevated levels of PAPP-A and free β-hCG, and such changes are independent of serum indicators of thyroid and liver function.

Cited by 38 publications

References 25 publications

Pregnancy outcomes in severe hyperemesis gravidarum in a multi-ethnic population

Pregnancy outcomes in severe hyperemesis gravidarum in a multi-ethnic population

Hyperemesis gravidarum: current perspectives

Treatments for hyperemesis gravidarum and nausea and vomiting in pregnancy: a systematic review and economic assessment

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