Nausea and vomiting of pregnancy - What's new?

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• 作者：Martha Bustos^a ; Raman Venkataramanan^a ; ^b ; Steve Caritis^c ; ^d ; ^{carisn@mail.magee.edu}
• 关键词：NVP ; Nausea and vomiting of pregnancy ; HG ; Hyperemesis gravidarum ; PUQE ; Pregnancy-Unique Quantification of Emesis scoring ; TNF-a ; Tumor necrosis factor alpha ; IL-1 ; Interleukin 1 ; IL-6 ; Interleukin 6 ; hCG ; Human chorionic gonadotrophin ; H. pylori ; Helicobacter pylori
• 刊名：Autonomic Neuroscience
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：202
• 期：Complete
• 页码：62-72
• 全文大小：530 K
• 卷排序：202

文摘

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.