Home Infusion Therapies for Obstetric Patients

Romeo, Cathy C.; Jones, Patsy

doi:10.1111/j.1552-6909.1994.tb01937.x

Cited by 4 publications

(1 citation statement)

References 4 publications

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“…3 As patient education is a vital component of therapy for hyperemesis gravidarum, the home care nurse can take advantage of this unique opportunity to provide individualized education in response to the observed environment. 19 Treatments for hyperemesis represent a wide spectrum of scientifically derived and empirical approaches. An incomplete list of treatments includes: rest, ingestion of placental extract, hormones, corticosteroids, vitamins, i.v.…”

Section: Discussionmentioning

confidence: 99%

Home Subcutaneous Metoclopramide Therapy for Hyperemesis Gravidarum

Buttino

Coleman²,

Bergauer³

et al. 2000

J Perinatol

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OBJECTIVE:To describe the use of subcutaneous (s.c.) metoclopramide in the outpatient treatment of hyperemesis gravidarum. STUDY DESIGN:In a retrospective design, women who received continuous s.c. metoclopramide for treatment of hyperemesis gravidarum were identified from a national database. Data analysis included weight at start and stop of treatment, frequency of resolution of symptoms, and side effects of medication. In addition, data were collected on adjuvant therapies. RESULTS:Between January and December of 1997, there were 646 women with hyperemesis gravidarum who received continuous s.c. metoclopramide on an outpatient basis. A total of 413 patients (63.9%) had complete resolution of symptoms. Seventy-five percent of patients had received one or more antiemetic medications before initiation of s.c. metoclopramide. A total of 192 patients (30.5%) reported at least one side effect related to treatment. The majority of reported side effects were considered mild and did not require discontinuation of s.c. metoclopramide. CONCLUSION:S.c. metoclopramide appears to be a safe, effective treatment for hyperemesis gravidarum. Outpatient treatment may result in decreased costs compared with inpatient hospitalization. Journal of Perinatology 2000; 20:359-362.Hyperemesis gravidarum is characterized by intractable nausea and vomiting during pregnancy with concurrent disturbances of nutrition and fluid balances. While nausea and vomiting afflicts 60% to 70% of pregnant women, hyperemesis gravidarum is relatively uncommon, occurring in ϳ5 per 1000 pregnancies.1 Ultimately, hyperemesis gravidarum accounts for ϳ4% to 7% of all antenatal hospital admissions and 30% of admissions before 20 weeks' gestation. 2When patients experience hyperemesis gravidarum, there is significant disruption in their lives, and there is a high cost to society. In a review of hyperemesis gravidarum by Cowan, 3 women reported curtailing social contacts. They also reported that relationships with spouses and families were altered. Vellacott et al. 4 reported that 183 of 243 pregnant women experienced nausea and vomiting in pregnancy, and 47% of these women felt that their job efficiency was reduced. Gadsby et al.1 have estimated that in England, some 8.6 million hours of paid employment and 5.8 million hours of housework are being lost through nausea and vomiting in pregnancy of all severities each year.Traditionally, this condition has resulted in costly management and loss of productivity due to prolonged and/or recurrent hospital admissions, as well as physical and emotional sequela. According to the Healthcare Cost and Utilization Project (HCUP), the average charge for patients treated for ICD-9-CM 643.13 (Hyperemesis with Metabolic Disturbances-Antepartum) in the hospital is $1291.33 per day.5 Studies looking at patients with hyperemesis gravidarum have reported frequent hospital admissions. 2,6,7 In one such study, 28% (39 of 140) of patients with hyperemesis gravidarum were admitted to the hospital 2.9 times on average (range 2 to 6 time...

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Section: Discussionmentioning

confidence: 99%

Home Subcutaneous Metoclopramide Therapy for Hyperemesis Gravidarum

Buttino

Coleman²,

Bergauer³

et al. 2000

J Perinatol

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Antepartum Home Care for High-Risk Pregnant Women

Heaman¹

1998

AACN Clinical Issues: Advanced Practice in Acute and Critical C

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Home care for women experiencing complications of pregnancy is a rapidly growing specialty. A variety of models of antepartum home care have emerged. Provision of effective antepartum home care requires knowledge and clinical skills in perinatal and home health nursing and an understanding of the structure and function of the home health care system. Nursing care in the home encompasses case coordination, maternal and fetal assessment, maternal education regarding the woman's risk situation and self-monitoring requirements, and provision of support. Antepartum home care for conditions such as hypertension in pregnancy, preterm labor, and hyperemesis gravidarum is discussed.

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Home Care of the Patient With Gynecologic Cancer

Lowdermilk

1995

Journal of Obstetric, Gynecologic & Neonatal Nursing

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Home Infusion Therapies for Obstetric Patients

Cited by 4 publications

References 4 publications

Home Subcutaneous Metoclopramide Therapy for Hyperemesis Gravidarum

Home Subcutaneous Metoclopramide Therapy for Hyperemesis Gravidarum

Antepartum Home Care for High-Risk Pregnant Women

Home Care of the Patient With Gynecologic Cancer

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