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hyperemesis gravidarum [keywords]
- Assessment of body composition with bioelectrical impedance analysis in pregnant women with hyperemesis gravidarum before and after treatment. [JOURNAL ARTICLE]
- J Obstet Gynaecol 2014 Nov 19.:1-4.
More than half of pregnant women suffer from nausea and vomiting, in 0.5-1% of the pregnant women, if nausea and vomiting are severe and persistent, condition can progress to hyperemesis. We evaluated the fluid volume parameters in pregnant women with hyperemesis gravidarum, before and after treatment using the bioelectrical impedance vectors. A total of 70 pregnant women who had weight loss exceeding 5% of pre-pregnancy body weight were recruited for the study in the first trimester. The measurement of multi-frequency bioelectrical impedance analysis parameters was performed on the day of hospitalisation before any treatment and after treatment at 24 h and 72 h with the same procedure. Total body water, extracellular water, intracellular water, and fat-free mass index increased after treatment at 24 h (P < 0.01). Also, the mean pregnancy-unique quantification of emesis and nausea score was significantly lower after treatment (11.3 ± 2.1 at enrolment, 5.1 ± 1.4 at 24 h and 4.3 ± 1.1 at 72 h) (P < 0.01), which correlated with the patients' clinical improvement and changes in hydration. In pregnant women with moderate-to-severe hyperemesis gravidarum, significant body composition changes occur and fluid replacement therapy performed during a short period of time, such as 24 h, provides improvement in body composition.
- Evaluation of the relationship between Helicobacter Pylori infection and Hyperemesis Gravidarum. [Journal Article]
- Med J Islam Repub Iran 2014.:72.
Hyperemesis gravidarum (HEG) is one of the many problems during pregnancy; its etiology has not been clearly understood. Inflammatory factors like helicobacter pylori infection has been considered as a risk factor in some studies. The purpose of the present study is to find a relationship between Helicobacter Pylori (H.P) infection and hyperemesis gravidarum (HEG).A case control study was performed on two groups of pregnant women who were in the first trimester of their pregnancies. Case group were pregnant women with hyperemesis gravidarum and control group were pregnant women with the same gestational age but without hyperemesis gravidarum. In both groups, IgG for H.P was measured and compared between the 2 groups.Totally, 175 pregnant women were evaluated; 78 women with HEG and 97 without. Both groups had no statistically significant difference according to age, gestational age, gravidity, and body mass index (BMI). 51 women out of 78 (65.4%) in HEG group and 43 women (44.3%) in the control group were IgG positive for HP, which showed a significant difference (p=0.005); OR= 2.37, CI 95%= 1.28-4.38. Also, mean serum level of IgG was higher in the HEG group (42.1 ± 3.75 VS 32.6 ± 3.65, p= 0.05). Between the different variables of age, gestational age, gravidity and HP infection, only HP infection was found as a risk factor for HEG using logistic regression model (p=0.011); OR= 2.522, CI 95%= 1.23-5.14.HP infection is higher in HEG cases and may be considered as its risk factor.
- A novel study on transdermal clonidine treatment of hyperemesis gravidarum. [Journal Article]
- BJOG 2014 Nov; 121(12):1563.
- Psychiatric factors do not affect recurrence risk of hyperemesis gravidarum. [JOURNAL ARTICLE]
- J Obstet Gynaecol Res 2014 Oct 27.
The aim of this study is to determine whether psychiatric symptoms affect recurrence risk of hyperemesis gravidarum (HG).The study sample included 108 women with HG treated with i.v. fluids in their first pregnancy. Women were divided into two groups based on recurrence of HG in their second pregnancy. Participants submitted medical records and completed a survey regarding pregnancy characteristics and psychiatric symptoms. The χ(2) -test and Student's t-test were performed to compare the two groups.Eighty-four women (71%) had a recurrence of HG requiring i.v. fluid for dehydration, and were compared with 34 women (29%) who did not have a recurrence. There were no significant differences in obstetric history, although there was a trend toward greater time between first and second pregnancy in the recurrence group (P = 0.08). There were no differences in pre-existing psychiatric diagnoses including anxiety, depression, bipolar disorder, panic or eating disorders. Following the first HG pregnancy, participants in both groups were well matched for all post-traumatic stress symptoms.This study is the first to analyze the relationship of psychiatric factors to risk of recurrence of HG. No factors were identified that increase the risk of recurrence including stress symptoms following a HG pregnancy. Psychological sequelae associated with HG are probably a result of the physical symptoms of prolonged severe nausea and vomiting, medication and/or hospitalization, and likely play no role in disease etiology.
- Hamman and Boerhaave syndromes - diagnostic dilemmas in a patient presenting with hyperemesis gravidarum: a case report. [Journal Article]
- Scott Med J 2014 Nov; 59(4):e12-6.
Hyperemesis gravidarum describes persistent vomiting leading to fluid and electrolyte imbalance. It is the commonest reason for admission in the first half of pregnancy. We describe a case of Hamman syndrome secondary to hyperemesis gravidarum. We also discuss Boerhaave syndrome: a particularly rare condition with only a handful of cases being described in the literature.A 17 year old admitted with hyperemesis gravidarum was diagnosed with Hamman syndrome after complaining of chest pain due to the presence of subcutaneous emphysema and pneumomediastinum on chest radiograph. She was treated conservatively for potential ruptured oesophagus but then self-discharged against medical advice.Subcutaneous emphysema is an alarming finding in any pregnancy and should be treated in a timely and cautious manner. This case report adds weight to the previous literature advocating a conservative versus surgical approach to the management of a woman with Hamman syndrome secondary to hyperemesis gravidarum.
- Disturbed release of cholecystokinin in pregnant women with hyperemesis gravidarum. [JOURNAL ARTICLE]
- J Obstet Gynaecol Res 2014 Oct 20.
We aimed to investigate cholecystokinin (CCK) release in pregnant women with and without hyperemesis gravidarum (HG).In this case-control study including 40 pregnant women with HG and 40 women with healthy uncomplicated pregnancies, serum CCK levels in addition to hematological, biochemical and hormonal parameters were investigated.Serum CCK values were found to be significantly lower in pregnant women with HG (P < 0.001). Additionally, while serum blood urea nitrogen and free thyroxine levels were significantly higher, sodium, potassium, and thyroid stimulating hormone levels were significantly lower in women with HG than in control women. No correlation was detected between CCK and other parameters like ketonuria and thyroid function tests.CCK release has been found to be halved in pregnant women with HG, which supports the hypothesis that gastrointestinal motility is increased in pregnant women with HG. A causal effect remains to be confirmed.
- The oxidative stress index increases among patients with hyperemesis gravidarum but not in normal pregnancies. [JOURNAL ARTICLE]
- Redox Rep 2014 Oct 18.
Objective The etiology and pathogenesis of hyperemesis gravidarum (HG) is still undetermined and has been suggested to involve oxidative stress. We aimed to evaluate the status of oxidative stress in HG by measuring the levels of total oxidant status (TOS), total antioxidant status (TAS), and by calculating the oxidative stress index (OSI). Methods In a case-control trial, fasting morning blood samples of patients with HG (n = 41) and healthy pregnant women (n = 39) were collected for analysis of serum TOS and TAS values as well as for calculation of OSI according to the formula: OSI = TOS / TAS × 100. Results Serum TOS and TAS levels were similar in both groups. However, serum TAS levels were lower among HG patients compared to controls, which resulted in an increase in OSI (P = 0.025). Discussion The present study supports the role of systemic oxidative stress, reflected by an imbalance between the TOS and TAS, in patients with HG. Our findings distinguish the mechanism underlying oxidative stress to result from reduction of antioxidants rather than an increase in oxidants.
- Clinical course and management of acute and chronic viral hepatitis during pregnancy. [JOURNAL ARTICLE]
- J Viral Hepat 2014 Oct 7.
Pregnancy is a para-physiologic condition, which usually evolves without any complications in the majority of women, even if in some circumstances moderate or severe clinical problems can also occur. Among complications occurring during the second and the third trimester very important are those considered as concurrent to pregnancy such as hyperemesis gravidarum, intrahepatic cholestasis of pregnancy, HELLP syndrome and acute fatty liver of pregnancy. The liver diseases concurrent to pregnancy typically occur at specific times during the gestation and they may lead to significant maternal and foetal morbidity and mortality. Commonly, delivery of the foetus, even preterm, usually terminates the progression of these disorders. All chronic liver diseases, such as chronic viral hepatitis, autoimmune hepatitis, Wilson's disease, and cirrhosis of different aetiologies may cause liver damage, independently from pregnancy. In this review we will also comment the clinical implications of pregnancies occurring in women who received a orthotopic liver transplantation (OLT) Therefore, the management of immunosuppressive therapy before and after the delivery in women who received liver transplant is becoming a relevant clinical issue. Finally, we will focus on acute and chronic viral hepatitis occurring during pregnancy, on management of advanced liver disease and we will review the literature on the challenging issue regarding pregnancy and OLT.
- Marijuana use and maternal experiences of severe nausea during pregnancy in Hawai'i. [Journal Article, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.]
- Hawaii J Med Public Health 2014 Sep; 73(9):283-7.
Recreational use of marijuana is relatively common in the United States, and medicinal use is gaining popular and legal support. Marijuana has been proposed as a potential treatment for hyperemesis gravidarum. Research into this topic is complicated by associations between marijuana use and poor birth outcomes. Cannabinoid hyperemesis syndrome, which can cause severe nausea and vomiting in marijuana users, is another complicating factor. Hawai'i Pregnancy Risk Assessment Monitoring System data from 4,735 respondents were used to estimate prevalence of self-reported marijuana use during and in the month before pregnancy, as well as severe nausea during pregnancy. Data were weighted to be representative of all pregnancies resulting in live births in Hawai'i between 2009 and 2011. Prevalence ratios (PR) and 95% confidence intervals (CI) were computed to estimate associations. Of recently-pregnant women in Hawai'i, 6.0% reported using marijuana in the month before pregnancy, and 2.6% reported using marijuana during pregnancy. Approximately 21.2% reported severe nausea during pregnancy. Women who reported severe nausea during pregnancy were significantly more likely to report marijuana use during pregnancy (3.7% vs 2.3%; PR=1.63, 95% CI: 1.08-2.44). More research is needed to investigate the relationship between marijuana use and severe nausea during pregnancy, and to quantify associated risks to mother and fetus.
- [Two Cases of Wernicke´s Encephalopathy That Developed during Total Parenteral Nutrition in Colon Cancer Patients Treated with 5-Fluorouracil-based Chemotherapy]. [English Abstract, Journal Article]
- Korean J Gastroenterol 2014 Sep 25; 64(3):158-63.
Wernicke's encephalopathy (WE) caused by thiamine deficiency is an acute neurological disorder. Clinically, the classic triad of WE consists of ophthalmoplegia, ataxia, and mental status changes. Thiamine deficiency is known to occur commonly in chronic alcoholic patients. Sometimes, it can occur in patients after gastrointestinal surgery and in those with malabsorption. In addition, patients undergoing renal dialysis, suffering from hyperemesis gravidarum, receiving total parenteral nutrition (TPN), and being treated with chemotherapeutic agents are also prone to develop thiamine deficiency. Herein, we report two cases of WE that developed following simultaneous 5-fluorouracil (5-FU) chemotherapy and TPN in colon cancer patients which was successfully treated with thiamine administration.