Korean J Obstet Gynecol.  2010 Jan;53(1):15-22. 10.5468/kjog.2010.53.1.15.

The effectiveness of antiemetics in hyperemesis gravidarum

Affiliations
  • 1Department of obstetrics and gynecology, Gil Hospital, Graduate school of medicine, Gachon university of medicine and science, Incheon, Korea. ksyob@gilhospital.com

Abstract

Nausea and vomiting occur in up to 80% of normal pregnancies. Hyperemesis gravidarum, resulting in dehydration and ketonuria, is a more severe and disabling condition affecting up to 1.5% of pregnancies. This condition is poorly understood and treatment strategies remain largely supportive with the aims of relieving symptoms and preventing complications of the disease. Treatment is supportive with intravenous hydration, antiemetics and correction of vitamin deficiency to minimize complications. There are good data to support the safety and usefulness of some kinds of antiemetics such as antihistamine, phenothiazines metoclopromide and specific HHT3 antagonists in hyperemesis gravidarum. But there is little evidence on which to choose the optimum therapy. This review discusses the diagnosis and management of hyperemesis gravidarum and the prevention, recognition and treatment of the serious complication

Keyword

Hyperemesis gravidarum; Nausea; Vomiting; Antiemetics

MeSH Terms

Antiemetics
Avitaminosis
Dehydration
Female
Hyperemesis Gravidarum
Ketosis
Nausea
Phenothiazines
Pregnancy
Vomiting
Antiemetics
Phenothiazines

Reference

1. Gadsby R, Barnie-Adshead AM, Jagger C. A prospective study of nausea and vomiting during pregnancy. Br J Gen Pract. 1993. 43:245–248.
2. Vellacott ID, Cooke EJ, James CE. Nausea and vomiting in early pregnancy. In J Gynaecol Obstet. 1988. 27:57–62.
3. Weigel RM, Weigel MM. nausea and vomiting of early pregnancy and pregnancy outcomes: a meta-analytical review. Br J Obstet Gynaecol. 1989. 96:1312–1318.
4. Deuchar N. Nausea and vomiting in pregnancy: a review of the problem with particular regard to psychological and social aspects. Br J Obstet Gynaecol. 1995. 102:6–8.
5. Lo WY, Friedman JM. Teratogenicity of recently introduced medications in human pregnancy. Obstet Gynecol. 2002. 100:465–473.
6. Matok I, Gorodischer R, Koren G, Sheiner E, Wiznitzer A, Levy A. The safety of metoclopramide use in the first trimester of pregnancy. N Engl J Med. 2009. 360:2528–2535.
7. Fell DB, Dodds I, Joseph KS, Allen VM, Butler B. Risk factors for hyperemesis gravidarum requiring hospital admission during pregnancy. Obstet Gynecol. 2006. 107(2 Pt 1):277–284.
8. Poursharif B, Korst LM, Fejzo MS, MacGibbon KW, Romero R, Goodwin TM. The psychosocial burden of illness of hyperemesis gravidarum. J Perinatol. 2008. 28:176–181.
9. Verberg MF, Gillott DJ, Al-Farden N, Grudzinskas JG. Hyperemesis gravidarum, a literature review. Hum Reprod Update. 2005. 11:527–539.
10. Golberg D, Szilagyi A, Graves L. Hyperemesis gravidarum and helicobactor pylori infection: a systematic review. Obstet Gynecol. 2007. 110:695–703.
11. Bottemley C, Bourne T. Management strategies for hyperemesis. Best Pract Res Clin Obstet Gynaecol. 2009. 23:549–564.
12. Goodwin TM, Montoro M, Mestman JH. Transient hyperthyroidism and hyperemesis gravidarum: clinical aspects. Am J Obstet Gynecol. 1992. 167:648–652.
13. Tan JY, Loh KC, Yeo GS, Chee YC. Transient hyperthyroidism of hyperemesis gravidarum. BJOG. 2002. 109:683–688.
14. Koren G, Boskovic R, Hard M, Maltepe C, Navioz Y, Einarson A. Motherrisk-PUQE (pregnancy-unique quantification of emesis and nausea) scoring system for nausea and vomiting of pregnancy. Am J Obstet Gynecol. 2002. 186:5 Suppl Understanding. S228–S231.
15. Lacasse A, Rey E, Ferreira E, Morin C, Bérard A. Validity of modified pregnancy-unique quantification of emesis and nausea (PUQE) scoring index to assess severity of nausea and vomiting of pregnancy. Am J Obstet Gynecol. 2008. 198:71.e1–71.e7.
16. Alalade AO, Khan R, Dwalatly B. Day-case management of hyperemesis gravidarum: feasibility and clinical efficacy. J Obstet Gynaecol. 2007. 27:363–364.
17. Bottomley C. Randomised trial of rapid outpatient rehydration versus hospital admission for hyperemesis gravidarum. ISRCTN4784769. 2008. Available from: URL: Http//www.controlled- trials.com/isrctn/281/10/3/desc/ http//www.controlled- trials.com/isrctn/281/10/3/desc/.
18. Kirk E, Papageorghiou AT, Condous G, Bottomley C, Bourne T. Hyperemesis gravidarum: is an ultrasound scan necessary? Hum Reprod. 2006. 21:2440–2442.
19. Castillo RA, Ray RA, Yaghmai F. Central pontine myelinolysis and pregnancy. Obstet Gynecol. 1989. 73(3 Pt 2):459–461.
20. Bergin PS, Harvey P. Wernicke's encephalopathy and central pontine myelinolysis associated with hyperemesis gravidarum. BMJ. 1992. 305:517–518.
21. Jewell D, Young G. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Sys Rev. 2003. 4:CD000145.
22. Gill SK, Einarson A. The safety of drugs for the treatment of nausea and vomiting of pregnancy. Expert Opin Drug Saf. 2007. 6:685–694.
23. Seto A, Einarson T, Koren G. Pregnancy outcome following first trimester exposure to antihistamines: meta-analysis. Am J Perinatol. 1997. 14:119–124.
24. Goodwin TM, Poursharif B, Krost LM, MacGibbon KW, Romero R, Fejzo MS. Secular trends in the treatment of hyperemesis gravidarum. Am J Perinatol. 2008. 25:141–147.
25. Cooper RL, Milam SB, Croft LK. Acute dystonic reaction to neuroleptic drugs. Anesth Prog. 1984. 31:175–177.
26. Tucker ML, Jackson MR, Scale MD, Spurling NW, Tweats DJ, Capel-Edwards K. Ondansteron: pre-clinical safety evaluation. Eur J Cancer Clin Oncol. 1980. 25 Suppl 1:S79–S93.
27. Safari HR, Fassett MJ, Souter IC, Alsulyman OM, Goodwin TM. The efficacy of methylprednisonelone in the treatment of hyperemesis gravidarum:a randomized, double-blind, cotrolled study. Am J Obstet Gynecol. 1998. 179:921–924.
28. Nelson-Piercy C, Fayers P, de Swiet M. Randomised, double-blind, placebo-controlled trial of corticosteroids for treatment of hyperemesis gravidarum. BJOG. 2001. 108:9–15.
29. Fischer-Rasmussen W, Kjaer SK, Dahl C, Asping U. Ginger treatment of hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol. 1991. 38:19–24.
30. Brent RL. Bendectin: review of the medical literature of a comprehensively studied human nonteratogen and most prevalent tortogen-litigen. Reprod Toxicol. 1995. 9:337–349.
31. Magee LA, Mazzotta P, Koren G. Evidence-based view of safety and effectiveness of pharmacologic therapy for nausea and vomiting of pregnancy (NVP). Am J Obstet Gynecol. 2002. 186:5 Suppl Understanding. S256–S261.
32. Knight B, Mudge C, Opehshaw S, White A, Hart A. Effect of acupuncture on nausea of pregnancy: a randomized, controlled trial. Obstet Gynecol. 2001. 97:184–188.
33. Rosen T, de Veciana M, Miller HS, Stewart L, Rebarber A, Slotnick RN. A randomized controlled trial of nerve stimulation for relief of nausea and vomiting in pregnancy. Obstet Gynecol. 2003. 102:129–135.
34. Werntoft E, Dykes AK. Effect of acupressure on nausea and vomiting during pregnancy. A randomized, placebo-controlled, pilot study. J Reprod Med. 2001. 46:835–839.
35. Heazell A, Thorneycroft J, Walton V, Etherington I. Acupressure for the in-patient treatment of nausea and vomiting in early pregnancy: a randomized control trial. Am J Obstet Gynecol. 2006. 194:815–820.
36. Buckwalter JG, Simpson SW. Psychological factors in the etiology and treatment of severe nausea and vomiting in pregnancy. Am J Obstet GYnecol. 2002. 186:5 Suppl Understanding. S210–S214.
37. Swallow BL, Lindow SW, Masson EA, Hay DM. Psychological health in early pregnancy: relationship with nausea and vomiting. J Obstet Gynaecol. 2004. 24:28–32.
38. Dodds L, Fell DB, Joseph KS, Allen VM, Butler B. Outcomes of pregnancies complicated by hyperemesis gravidarum. Obstet Gynecol. 2006. 107(2 Pt 1):285–292.
39. Tan PC, Jacob R, Quek KF, Omar SZ. Pregnancy outcome in hyperemesis gravidarum and the effect of laboratory clinical indicators of hyperemesis severity. J Obstet Gynaecol Res. 2007. 33:457–464.
40. Trogstad LI, Stoltenberg C, Magnus P, Skjaerven R, Irgens LM. Recurrence risk in hyperemesis gravidarum. BJOG. 2005. 112:1641–1645.
41. Koren G. Pre-emptic therapy for severe nausea and vomiting of pregnancy and hyperemesis gravidarum. J Obstet Gynaecol. 2004. 24:530–533.
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