Hyperemesis gravidarum: pathogenesis and the use of antiemetic agents

Sanu, Olaleye; Lamont, Ronald F.

doi:10.1517/14656566.2010.537655

Cited by 23 publications

(23 citation statements)

References 94 publications

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“…This is based largely on the temporal relationship between the peak of NVP and the peak of hCG production, both of which occur simultaneously with the most intense symptoms of NVP—weeks 9 to12 of gestation (Braunstein et al, 1976; Patil et al, 2012). Besides, hCG levels plateau or decline in a similar manner to the resolution of the HG symptoms (Sanu et al, 2011). In addition, nausea and vomiting are often worse in pregnant women with conditions associated with elevated hCG levels such as molar pregnancies, multiple gestations, Down syndrome and pregnancies of female fetuses (Davis, 2004; Niebyl, 2010; Verberg et al, 2005).…”

Section: Pathogenesismentioning

confidence: 99%

“…This drug combination has been widely used in different countries around the world (Zur, 2013) and several studies and meta-analyses over the last 3 decades support its efficacy (2004; Niebyl et al, 2002) as well as its fetal and maternal safety (Einarson et al, 1988; Holmes, 1983; Koren et al, 2015; Madjunkova et al, 2014; McKeigue et al, 1994). Drowsiness is the most common side effect reported for this drug (Sanu et al, 2011). A factor that may affect the utility of this and other oral medications is the inability of some women with NVP or HG to swallow any oral medication (Zur, 2013).…”

Section: Treatmentmentioning

confidence: 99%

“…This benzamide increases gastric transit and corrects gastric dysrhythmias by stimulating antral contractions and promoting antroduodenal contractions (Lee et al, 2011). Metoclopramide is pregnancy category B and its use during pregnancy has shown to be free of any increased risk of congenital malformations, low birth weight, preterm delivery, or perinatal death (Matok et al, 2009; Milkovich et al, 1976; Sanu et al, 2011; Sorensen et al, 2000). Despite its efficacy, metoclopramide use is limited by its side effects which includes drowsiness, dizziness, dystonia and the risk of tardive dyskinesia with chronic use (Lee et al, 2011; Tan et al, 2010).…”

Section: Treatmentmentioning

confidence: 99%

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Nausea and vomiting of pregnancy - What's new?

Bustos

Venkataramanan²,

Caritis

2017

Autonomic Neuroscience

113

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Nausea and vomiting of pregnancy (NVP) is one of the most common disorders of pregnancy. The symptoms occur predominantly during the first trimester, although in a subgroup of patients they can continue throughout the entire pregnancy and can affect the woman’s quality of life. A small percentage of women develop a severe form of NVP called hyperemesis gravidarum (HG) that if left untreated may lead to significant maternal morbidity and adverse birth outcomes. Overall, the morbidity in pregnant women with NVP is significant, although it tends to be underestimated. The pathogenesis of NVP remains unclear, but there is consensus that the disorder is multifactorial and that various genetic, endocrine and infectious factors may be involved. The treatment of NVP can be challenging as the optimal targets for therapy are not known. Currently, the therapy used depends on the severity of the disorder and it is focused on improving the symptoms while minimizing risks to mother and fetus. Therapies range from dietary changes, pharmacologic treatment or hospitalization with intravenous fluid replacement and nutrition therapy. The aims of this review are 1) to provide an overview of NVP, 2) to present possible links between the most important factors associated with the pathogenesis of NVP and 3) to discuss the effectiveness and safety of the pharmacologic and non-pharmacologic options available to treat this disorder.

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Section: Pathogenesismentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

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Nausea and vomiting of pregnancy - What's new?

Bustos

Venkataramanan²,

Caritis

2017

Autonomic Neuroscience

113

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“…HG is most likely a multifactorial condition and has been associated with many risk factors 19. Women with HG are more likely to be younger, primiparous, persons of color, and less likely to drink alcohol 20,21.…”

Section: Risk Factors For Hgmentioning

confidence: 99%

Hyperemesis gravidarum: current perspectives

McCarthy¹,

Lutomski²,

Greene³

2014

IJWH

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“…The prevalence of HG varies between 0.3 and 3.2%, depending on the maternal country of birth 14, 15. The aetiology is poorly understood, and previous studies suggest different causal mechanisms, involving placental dysfunction, gastrointestinal pathology, immunologic factors and endocrine and metabolic factors 16, 17, 18, 19, 20, 21. Although HG is the most common reason for hospitalisation during the first trimester,22 little is known about the long‐term consequences of HG exposure.…”

Section: Introductionmentioning

confidence: 99%

Hyperemesis gravidarum and long‐term mortality: a population‐based cohort study

Fossum

Vikanes

Næss

et al. 2016

BJOG

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ObjectiveTo investigate whether exposure to hyperemesis gravidarum (HG) is associated with increased maternal long‐term mortality.DesignPopulation‐based cohort study.SettingMedical Birth Registry of Norway (1967–2002) linked to the Cause of Death Registry.PopulationWomen in Norway with singleton births in the period 1967–2002, with and without HG. Women were followed until 2009 or death.MethodsCox proportional hazard regression model was applied to estimate hazard ratios (HRs) with 95% confidence interval (CI).Main outcome measuresThe primary outcome was all‐cause mortality during follow up. Secondary outcomes were cause‐specific mortality (cardiovascular mortality, deaths due to cancer, external causes or mental and behavioural disorders).ResultsOf 999 161 women with singleton births, 13 397 (1.3%) experienced HG. During a median follow up of 26 years (25 902 036 person‐years), 43 470 women died (4.4%). Women exposed to HG had a lower risk of long‐term all‐cause mortality compared with women without HG (crude HR 0.82; 95% CI 0.75–0.90). When adjusting for confounders, this reduction was no longer significant (adjusted HR 0.92; 95% CI 0.84–1.01). Women exposed to HG had a similar risk of cardiovascular death as women not exposed (adjusted HR 1.04; 95% CI 0.83–1.29), but a lower long‐term risk of death from cancer (adjusted HR 0.86; 95% CI 0.75–0.98).ConclusionIn this large population‐based cohort study, HG was not associated with an increased risk of long‐term all‐cause mortality. Women exposed to HG had no increase in mortality due to cardiovascular disease, but had a reduced risk of death from cancer.Tweetable abstractPopulation‐based cohort study: Hyperemesis was not associated with an increased risk of long‐term mortality.

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Hyperemesis gravidarum: pathogenesis and the use of antiemetic agents

Abstract: The precise mechanism underlying hyperemesis gravidarum remains unclear, but appears to be multifactorial. As yet there is no evidence that any antiemetic class is superior to another with respect to effectiveness.

Cited by 23 publications

References 94 publications

Nausea and vomiting of pregnancy - What's new?

Nausea and vomiting of pregnancy - What's new?

Hyperemesis gravidarum: current perspectives

Hyperemesis gravidarum and long‐term mortality: a population‐based cohort study

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