| Pre-emptive therapy for severe nausea and vomiting of pregnancy and hyperemesis gravidarum. | |
| | |
MedLine Citation:
|
PMID: 15369934 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Nausea and vomiting of pregnancy (NVP) affects 80% of pregnancies. Its severe form, hyperemesis gravidarum (HG), results in dehydration, electrolyte imbalance, the need for hospitalisation and can, rarely, be fatal. This was a prospective, open-labelled, controlled, interventional study to evaluate the effectiveness of pre-emptive treatment of NVP symptoms in women who experienced severe NVP or HG in their previous pregnancy. Twenty-five women who reported severe symptoms of NVP with or without HG in their previous pregnancy were recruited and counselled to commence the use of antiemetics as soon as they became aware of the present pregnancy, and no later than the beginning of symptoms. They were followed-up prospectively through the index pregnancy for symptoms of NVP, and were counselled continuously as to how to modify antiemetic doses based on symptoms. A comparison group consisted of randomly selected women also counselled by us for NVP, who had also had severe NVP in the previous pregnancy, but who did not call before a planned pregnancy and thus could not be offered pre-emptive therapy. The recruited women commenced pre-emptive drug therapy for NVP before conception or up to 7 weeks' gestation, before the appearance of NVP symptoms in all cases. In comparison to the previous pregnancy, only eight of these 18 women experienced a HG again in the index pregnancy (P = 0.01). The majority of study the women had an improvement in severity of NVP symptoms compared to the previous pregnancy. In the comparison group (n = 35), symptoms in the index pregnancy remained severe in 28 cases (80%), decreased to moderate in six (16.6%) and decreased to mild in five cases (13.9%). There were five cases of HG in the previous pregnancy and three in the index pregnancy. The pre-emptive group was improved significantly compared to the control group (P = 0.01). Pre-emptive symptom management appears to be effective in preventing severe NVP in general, and HG in particular. Women who have experienced severe NVP in a previous pregnancy may benefit from taking antiemetics before, or immediately at the start of symptoms in a subsequent pregnancy. |
| | |
Authors:
|
G Koren; Caroline Maltepe |
Related Documents
:
|
15198784 - Vegf expression in the placenta from pregnancies complicated by hypertensive disorders. 17091404 - Fetal gender and gestational-age-related incidence of pre-eclampsia. 1426514 - Management of eclampsia: cardiopulmonary arrest resulting from magnesium sulfate overdose. 9336024 - Drug management of hypertensive disorders of pregnancy. 1751444 - (patho)physiological implications of chronic dietary sodium restriction during pregnanc... 16203594 - The effect of malarial infection on maternal-fetal outcome in ecuador. |
Publication Detail:
|
Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology Volume: 24 ISSN: 0144-3615 ISO Abbreviation: J Obstet Gynaecol Publication Date: 2004 Aug |
Date Detail:
|
Created Date: 2004-09-16 Completed Date: 2004-10-15 Revised Date: 2009-10-16 |
Medline Journal Info:
|
Nlm Unique ID: 8309140 Medline TA: J Obstet Gynaecol Country: England |
Other Details:
|
Languages: eng Pagination: 530-3 Citation Subset: IM |
Affiliation:
|
Motherisk Program, Division of Clinical Pharmacology/Toxicology, The Hospital for Sick Children Toronto, University of Toronto, Canada. gkoren@sickkids.ca |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Antiemetics / administration & dosage* Doxylamine / administration & dosage Drug Administration Schedule Drug Combinations Female Fluid Therapy Humans Hyperemesis Gravidarum / drug therapy*, pathology Ondansetron / administration & dosage Pregnancy Prenatal Care Prospective Studies Pyridoxine / administration & dosage Severity of Illness Index Treatment Outcome Vitamin B 6 / administration & dosage |
| Chemical | |
Reg. No./Substance:
|
0/Antiemetics; 0/Drug Combinations; 0/doxylamine, pyridoxine drug combination; 469-21-6/Doxylamine; 65-23-6/Pyridoxine; 8059-24-3/Vitamin B 6; 99614-02-5/Ondansetron |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Symphysiotomy at the Mater Misericordiae Hospital Afikpo, Ebonyi State of Nigeria (1982-1999): a rev...
Next Document: Clinical audit of the use of tension-free vaginal tape as a surgical treatment for urinary stress in...