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Geburtshilfe Frauenheilkd 2011; 71(1): 26-37
DOI: 10.1055/s-0030-1250769
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Hyperemesis gravidarum

Hyperemesis GravidarumB. Böer1 , M. Hoopmann1 , M. Hübner1 , B. Yazdi1 , K. O. Kagan1 , H. Abele1
  • 1Perinatalzentrum Universitätsklinikum Tübingen, Tübingen
Further Information

Publication History

eingereicht 18.10.2010 revidiert 16.12.2010

akzeptiert 23.12.2010

Publication Date:
15 February 2011 (online)

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Zusammenfassung

Circa 80 % aller Frauen leiden während der Schwangerschaft an Übelkeit und Erbrechen. In bis zu 20 % der Fälle können die Symptome über die gesamte Gravidität beobachtet werden. Die Ursache ist nach heutigem Kenntnisstand multifaktoriell und nicht endgültig geklärt. Die Betroffenen zeigen ein über den Tag hinweg übermäßig häufiges Erbrechen. Die weiteren Beschwerden sind häufig unspezifisch. Für die Diagnose richtungsweisend sind v. a. die Klinik der Patientin und die Ergebnisse der Laboruntersuchung (Elektrolytentgleisung, Hämatokriterhöhung, Ketonurie etc.). Die Behandlung ist symptomatisch. Neben der medikamentösen Therapie (Vitamin B6, Antihistaminika, Anticholinergika und andere niedrig dosierte Antiemetika sowie gastrointestinal wirksame Medikamente) haben auch naturheilkundliche Verfahren (Akupunktur, Akupressur, Ingwer etc.) ihren Stellenwert. Darüber hinaus sollte die Indikation zur psychosomatischen und ‐therapeutischen Begleitbehandlung großzügig gestellt werden, da davon auszugehen ist, dass psychologische Faktoren in der Pathogenese eine gewichtige Rolle spielen. Bei ausgeprägtem Verlauf (Hyperemesis Grad II) ist eine stationäre Behandlung indiziert.

Abstract

About 80 % of pregnant women suffer from nausea and vomiting and about 20 % will remain symptomatic throughout the whole course of pregnancy. The origin is not fully clarified and is believed to be multifactorial. The key symptoms that point towards the diagnosis of hyperemesis gravidarum consist of the clinical presentation and changes in the blood and urine analysis (increasing hematocrit, ketonuria, dysbalance of electrolytes, etc.). The treatment is symptomatic and consists of vitamin B6, antihistaminics, anticholinergics and other low dosed anti-emetics. Alternative approaches such as acupuncture, acupressure, ginger, etc. also play an important role. As psychological factors may often be of importance, psychosomatic treatment should always be considered. If the clinical symptoms are more pronounced (hyperemesis gravidarum level 2), an inpatient treatment should be considered.

Schlüsselwörter

Übelkeit - Erbrechen - Schwangerschaft - Hyperemesis gravidarum

Key words

nausea - vomiting - pregnancy - hyperemesis gravidarum

Literatur

  • 1 Gadsby R, Barnie-Adshead A M, Jagger C. A prospective study of nausea and vomiting during pregnancy.  Br J Gen Pract. 1993;  43 245-248
    PubMedGoogle Scholar
  • 2 Sheehan P. Hyperemesis gravidarum – assessment and management.  Aust Fam Physician. 2007;  36 698-701
    PubMedGoogle Scholar
  • 3 Lacroix R, Eason E, Melzack R. Nausea and vomiting during pregnancy: A prospective study of its frequency, intensity, and patterns of change.  Am J Obstet Gynecol. 2000;  182 931-937
    CrossrefPubMedGoogle Scholar
  • 4 Broussard C N, Richter J E. Nausea and vomiting of pregnancy.  Gastroenterol Clin North Am. 1998;  27 123-151
    CrossrefPubMedGoogle Scholar
  • 5 Jordan V, MacDonald J, Crichton S et al. The incidence of hyperemesis gravidarum is increased among Pacific Islanders living in Wellington.  N Z Med J. 1995;  108 342-344
    PubMedGoogle Scholar
  • 6 Kallen B. Hyperemesis during pregnancy and delivery outcome: a registry study.  Eur J Obstet Gynecol Reprod Biol. 1987;  26 291-302
    CrossrefPubMedGoogle Scholar
  • 7 Tsang I S, Katz V L, Wells S D. Maternal and fetal outcomes in hyperemesis gravidarum.  Int J Gynaecol Obstet. 1996;  55 231-235
    CrossrefPubMedGoogle Scholar
  • 8 Fairweather D V. Nausea and vomiting in pregnancy.  Am J Obstet Gynecol. 1968;  102 135-175
    PubMedGoogle Scholar
  • 9 Bennett T A, Kotelchuck M, Cox C E et al. Pregnancy-associated hospitalizations in the United States in 1991 and 1992: a comprehensive view of maternal morbidity.  Am J Obstet Gynecol. 1998;  178 346-354
    CrossrefPubMedGoogle Scholar
  • 10 Miller F. Nausea and vomiting in pregnancy: the problem of perception – is it really a disease?.  Am J Obstet Gynecol. 2002;  186 (5 Suppl. Understanding) S182-S183
    CrossrefPubMedGoogle Scholar
  • 11 Statistisches Bundesamt .Gesundheit – Diagnosedaten der Patienten und Patientinnen in Krankenhäusern (einschl. Sterbe- und Stundenfälle), in Fachreihe 12 – Reihe 6.2.1. 2009.. Wiesbaden: Statistisches Bundesamt; 2009
    Google Scholar
  • 12 Mazzotta P, Maltepe C, Navioz Y et al. Attitudes, management and consequences of nausea and vomiting of pregnancy in the United States and Canada.  Int J Gynaecol Obstet. 2000;  70 359-365
    CrossrefPubMedGoogle Scholar
  • 13 Dodds L, Fell D B, Joseph K S et al. Outcomes of pregnancies complicated by hyperemesis gravidarum.  Obstet Gynecol. 2006;  107 (2 Pt 1) 285-292
    CrossrefPubMedGoogle Scholar
  • 14 Fukada Y, Ohta S, Mizuno K et al. Rhabdomyolysis secondary to hyperemesis gravidarum.  Acta Obstet Gynecol Scand. 1999;  78 71
    CrossrefPubMedGoogle Scholar
  • 15 Kanayama N, Khatun S, Belayet H M et al. Vasospasms of cerebral arteries in hyperemesis gravidarum.  Gynecol Obstet Invest. 1998;  46 139-141
    CrossrefPubMedGoogle Scholar
  • 16 Liang S G, Ooka F, Santo A et al. Pneumomediastinum following esophageal rupture associated with hyperemesis gravidarum.  J Obstet Gynaecol Res. 2002;  28 172-175
    CrossrefPubMedGoogle Scholar
  • 17 Robinson J N, Banerjee R, Thiet M P. Coagulopathy secondary to vitamin K deficiency in hyperemesis gravidarum.  Obstet Gynecol. 1998;  92 (4 Pt 2) 673-675
    CrossrefPubMedGoogle Scholar
  • 18 Peeters A, Van de Wyngaert F, Van Lierde M et al. Wernicke's encephalopathy and central pontine myelinolysis induced by hyperemesis gravidarum.  Acta Neurol Belg. 1993;  93 276-282
    PubMedGoogle Scholar
  • 19 Togay-Işikay C, Yiğit A, Mutluer N. Wernicke's encephalopathy due to hyperemesis gravidarum: an under-recognised condition.  Aust N Z J Obstet Gynaecol. 2001;  41 453-456
    CrossrefPubMedGoogle Scholar
  • 20 Fell D B, Dodds L, Joseph K S et al. Risk factors for hyperemesis gravidarum requiring hospital admission during pregnancy.  Obstet Gynecol. 2006;  107 (2 Pt 1) 277-284
    CrossrefPubMedGoogle Scholar
  • 21 Jarnfelt-Samsioe A, Samsioe G, Velinder G M. Nausea and vomiting in pregnancy – a contribution to its epidemiology.  Gynecol Obstet Invest. 1983;  16 221-229
    CrossrefPubMedGoogle Scholar
  • 22 Klebanoff M A, Koslowe P A, Kaslow R et al. Epidemiology of vomiting in early pregnancy.  Obstet Gynecol. 1985;  66 612-616
    PubMedGoogle Scholar
  • 23 Vikanes A, Grjibovski A M, Vangen S et al. Maternal body composition, smoking, and hyperemesis gravidarum.  Ann Epidemiol. 2010;  20 592-598
    CrossrefPubMedGoogle Scholar
  • 24 Zhang Y, Cantor R M, Macgibbon K et al. Familial aggregation of hyperemesis gravidarum.  Am J Obstet Gynecol. 2010; 
    Google Scholar
  • 25 Vikanes A, Skjaerven R, Grjibovski A M et al. Recurrence of hyperemesis gravidarum across generations: population based cohort study.  BMJ. 2010;  340 c2050
    PubMedGoogle Scholar
  • 26 Tan P C, Jacob R, Quek K F et al. The fetal sex ratio and metabolic, biochemical, haematological and clinical indicators of severity of hyperemesis gravidarum.  BJOG. 2006;  113 733-737
    PubMedGoogle Scholar
  • 27 Goecke T W, Ekici A B, Niesler B et al. Two naturally occurring variants of the serotonin receptor gene HTR3C are associated with nausea in pregnancy.  Acta Obstet Gynecol Scand. 2010;  89 7-14
    CrossrefPubMedGoogle Scholar
  • 28 Verberg M F, Gillott D J, Al-Fardan N et al. Hyperemesis gravidarum, a literature review.  Hum Reprod Update. 2005;  11 527-539
    CrossrefPubMedGoogle Scholar
  • 29 Cole L A. Biological functions of hCG and hCG-related molecules.  Reprod Biol Endocrinol. 2010;  8 102
    CrossrefPubMedGoogle Scholar
  • 30 Askling J, Erlandsson G, Kaijser M et al. Sickness in pregnancy and sex of child.  Lancet. 1999;  354 2053
    PubMedGoogle Scholar
  • 31 Basso O, Olsen J. Sex ratio and twinning in women with hyperemesis or pre-eclampsia.  Epidemiology. 2001;  12 747-749
    CrossrefPubMedGoogle Scholar
  • 32 Goodwin T M, Montoro M, Mestman J H et al. The role of chorionic gonadotropin in transient hyperthyroidism of hyperemesis gravidarum.  J Clin Endocrinol Metab. 1992;  75 1333-1337
    CrossrefPubMedGoogle Scholar
  • 33 Tojo S, Ashitaka Y, Nishimura R. HCG: Biology and Chemistry.. In: Grudzinskas J G, Teisner B, Seppala M, eds. Pregnancy Proteins, Biology, Chemistry and clinical Application.. Sydney: Academic Press; 1982: 29
    Google Scholar
  • 34 Power Z, Thomson A M, Waterman H. Understanding the stigma of hyperemesis gravidarum: qualitative findings from an action research study.  Birth. 2010;  37 237-244
    CrossrefPubMedGoogle Scholar
  • 35 Tempfer C. Physiologie und Therapie der Hyperemesis gravidarum.  Gynäkologe. 2001;  34 833-840
    CrossrefPubMedGoogle Scholar
  • 36 Panesar N S, Li C Y, Rogers M S. Are thyroid hormones or hCG responsible for hyperemesis gravidarum? A matched paired study in pregnant Chinese women.  Acta Obstet Gynecol Scand. 2001;  80 519-524
    CrossrefPubMedGoogle Scholar
  • 37 Fonseca E B, Celik E, Parra M et al. Progesterone and the risk of preterm birth among women with a short cervix.  N Engl J Med. 2007;  357 462-469
    CrossrefPubMedGoogle Scholar
  • 38 Böer B, Kagan K O, Hoopmann M et al. Kann Progesteron in der Schwangerschaft die Frühgeburtsrate senken?.  Geburtsh Frauenheilk. 2010;  70 672-674
    Article in Thieme ConnectPubMedGoogle Scholar
  • 39 Walsh J W, Hasler W L, Nugent C E et al. Progesterone and estrogen are potential mediators of gastric slow-wave dysrhythmias in nausea of pregnancy.  Am J Physiol. 1996;  270 (3 Pt 1) G506-G514
    PubMedGoogle Scholar
  • 40 Depue R H, Bernstein L, Ross R K et al. Hyperemesis gravidarum in relation to estradiol levels, pregnancy outcome, and other maternal factors: a seroepidemiologic study.  Am J Obstet Gynecol. 1987;  156 1137-1141
    CrossrefPubMedGoogle Scholar
  • 41 Jordan V, Grebe S K, Cooke R R et al. Acidic isoforms of chorionic gonadotrophin in European and Samoan women are associated with hyperemesis gravidarum and may be thyrotrophic.  Clin Endocrinol (Oxf). 1999;  50 619-627
    CrossrefPubMedGoogle Scholar
  • 42 Yoneyama Y, Suzuki S, Sawa R et al. The T-helper 1/T-helper 2 balance in peripheral blood of women with hyperemesis gravidarum.  Am J Obstet Gynecol. 2002;  187 1631-1635
    CrossrefPubMedGoogle Scholar
  • 43 James W H. The associated offspring sex ratios and cause(s) of hyperemesis gravidarum.  Acta Obstet Gynecol Scand. 2001;  80 378-379
    CrossrefPubMedGoogle Scholar
  • 44 Schiff M A, Reed S D, Daling J R. The sex ratio of pregnancies complicated by hospitalisation for hyperemesis gravidarum.  BJOG. 2004;  111 27-30
    PubMedGoogle Scholar
  • 45 Tan P C, Tan N C, Omar S Z. Effect of high levels of human chorionic gonadotropin and estradiol on the severity of hyperemesis gravidarum.  Clin Chem Lab Med. 2009;  47 165-171
    CrossrefPubMedGoogle Scholar
  • 46 Golberg D, Szilagyi A, Graves L. Hyperemesis gravidarum and Helicobacter pylori infection: a systematic review.  Obstet Gynecol. 2007;  110 695-703
    CrossrefPubMedGoogle Scholar
  • 47 Mansour G M, Nashaat E H. Role of Helicobacter pylori in the pathogenesis of hyperemesis gravidarum.  Arch Gynecol Obstet. 2010;  [Epub ahead of print]
    PubMedGoogle Scholar
  • 48 Fischbach W, Malfertheiner P, Hoffmann J C et al. S3-Guideline “Helicobacter pylori and gastroduodenal ulcer disease” of the German Society for Digestive and Metabolic Diseases (DGVS) in cooperation with the German Society for Hygiene and Microbiology, Society for Pediatric Gastroenterology and Nutrition e. V., German Society for Rheumatology, AWMF-Registration-no. 021/001.  Z Gastroenterol. 2009;  47 1230-1263
    Article in Thieme ConnectPubMedGoogle Scholar
  • 49 Schäfer C, Spielmann H, Vetter K. Arzneiverordnungen in der Schwangerschaft und Stillzeit.. 7. Aufl. München, Jena: Urban & Fischer; 2006
    Google Scholar
  • 50 Chan N N. Thyroid function in hyperemesis gravidarum.  Lancet. 1999;  353 2243
    PubMedGoogle Scholar
  • 51 Tan J Y, Loh K C, Yeo G S et al. Transient hyperthyroidism of hyperemesis gravidarum.  BJOG. 2002;  109 683-688
    CrossrefPubMedGoogle Scholar
  • 52 Soares C N, Zitek B. Reproductive hormone sensitivity and risk for depression across the female life cycle: a continuum of vulnerability?.  J Psychiatry Neurosci. 2008;  33 331-343
    PubMedGoogle Scholar
  • 53 Munch S. Chicken or the egg? The biological-psychological controversy surrounding hyperemesis gravidarum.  Soc Sci Med. 2002;  55 1267-1278
    CrossrefPubMedGoogle Scholar
  • 54 Fairweather D V. Nausea and vomiting during pregnancy.  Obstet Gynecol Annu. 1978;  7 91-105
    PubMedGoogle Scholar
  • 55 Bailit J L. Hyperemesis gravidarium: Epidemiologic findings from a large cohort.  Am J Obstet Gynecol. 2005;  193 (3 Pt 1) 811-814
    CrossrefPubMedGoogle Scholar
  • 56 Paauw J D, Bierling S, Cook C R et al. Hyperemesis gravidarum and fetal outcome.  JPEN J Parenter Enteral Nutr. 2005;  29 93-96
    CrossrefPubMedGoogle Scholar
  • 57 Czeizel A E, Sarkozi A, Wyszynski D F. Protective effect of hyperemesis gravidarum for nonsyndromic oral clefts.  Obstet Gynecol. 2003;  101 737-744
    CrossrefPubMedGoogle Scholar
  • 58 Mylonas I, Gingelmaier A, Kainer F. Erbrechen in der Schwangerschaft, Übersichtsarbeit.  Deutsches Ärzteblatt. 2007;  25 1821-1826
    PubMedGoogle Scholar
  • 59 Kirk E, Papageorghiou A T, Condous G et al. Hyperemesis gravidarum: is an ultrasound scan necessary?.  Hum Reprod. 2006;  21 2440-2442
    CrossrefPubMedGoogle Scholar
  • 60 Mylonas I. Hyperemesis gravidarum.. In: Kainer F, Hrsg. Facharzt Geburtsmedizin.. München, Jena: Urban & Fischer Verlag; 2006
    Google Scholar
  • 61 Goodwin T M. Hyperemesis gravidarum.  Clin Obstet Gynecol. 1998;  41 597-605
    CrossrefPubMedGoogle Scholar
  • 62 Quinlan J D, Hill D A. Nausea and vomiting of pregnancy.  Am Fam Physician. 2003;  68 121-128
    PubMedGoogle Scholar
  • 63 Schwentner L, Wulff C, Kreienberg R et al. Exacerbation of a maternal hiatus hernia in early pregnancy presenting with symptoms of hyperemesis gravidarum: case report and review of the literature.  Arch Gynecol Obstet. 2010;  [Epub ahead of print]
    Google Scholar
  • 64 Lewandowski K, Hincz P, Grzesiak M et al. New onset Addison's disease presenting as prolonged hyperemesis in early pregnancy.  Ginekol Pol. 2010;  81 537-540
    PubMedGoogle Scholar
  • 65 Pachydakis A, Koutroumanis P, Geyushi B et al. Primary hyperparathyroidism in pregnancy presenting as intractable hyperemesis complicating psychogenic anorexia: a case report.  J Reprod Med. 2008;  53 714-716
    PubMedGoogle Scholar
  • 66 Matthews A, Dowswell T, Haas D M et al. Interventions for nausea and vomiting in early pregnancy.  Cochrane Database Syst Rev. 2010;  CD007575
    PubMedGoogle Scholar
  • 67 Kim D R, Connolly K R, Cristancho P et al. Psychiatric consultation of patients with hyperemesis gravidarum.  Arch Womens Ment Health. 2009;  12 61-67
    CrossrefPubMedGoogle Scholar
  • 68 Pirimoglu Z M, Guzelmeric K, Alpay B et al. Psychological factors of hyperemesis gravidarum by using the SCL-90-R questionnaire.  Clin Exp Obstet Gynecol. 2010;  37 56-59
    PubMedGoogle Scholar
  • 69 Bühling K J, Bohnet H G. Ursachen und Therapie der Schwangerschaftsübelkeit.  Frauenarzt. 2006;  47 1110-1113
    PubMedGoogle Scholar
  • 70 Fischer-Rasmussen W, Kjaer S K, Dahl C et al. Ginger treatment of hyperemesis gravidarum.  Eur J Obstet Gynecol Reprod Biol. 1991;  38 19-24
    CrossrefPubMedGoogle Scholar
  • 71 Ismail S K, Kenny L. Review on hyperemesis gravidarum.  Best Pract Res Clin Gastroenterol. 2007;  21 755-769
    CrossrefPubMedGoogle Scholar
  • 72 Niebyl J R, Goodwin T M. Overview of nausea and vomiting of pregnancy with an emphasis on vitamins and ginger.  Am J Obstet Gynecol. 2002;  186 (5 Suppl. Understanding) S253-S255
    CrossrefPubMedGoogle Scholar
  • 73 Vutyavanich T, Kraisarin T, Ruangsri R. Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial.  Obstet Gynecol. 2001;  97 577-582
    CrossrefPubMedGoogle Scholar
  • 74 Jewell D. Nausea and vomiting in early pregnancy.  Clin Evid. 2003;  1561-1570
    PubMedGoogle Scholar
  • 75 Jewell D, Young G. Interventions for nausea and vomiting in early pregnancy.  Cochrane Database Syst Rev. 2003;  CD000145
    PubMedGoogle Scholar
  • 76 de Aloysio D, Penacchioni P. Morning sickness control in early pregnancy by Neiguan point acupressure.  Obstet Gynecol. 1992;  80 852-854
    PubMedGoogle Scholar
  • 77 Roscoe J A, Matteson S E. Acupressure and acustimulation bands for control of nausea: a brief review.  Am J Obstet Gynecol. 2002;  186 (5 Suppl. Understanding) S244-S247
    CrossrefPubMedGoogle Scholar
  • 78 Shin H S, Song Y A, Seo S. Effect of Nei-Guan point (P6) acupressure on ketonuria levels, nausea and vomiting in women with hyperemesis gravidarum.  J Adv Nurs. 2007;  59 510-519
    CrossrefPubMedGoogle Scholar
  • 79 Römer A. Akupunktur für Hebammen, Geburtshelfer und Gynäkologen.. 3. Aufl. Stuttgart: Hippokrates Verlag; 2002
    Google Scholar
  • 80 Sahakian V, Rouse D, Sipes S et al. Vitamin B6 is effective therapy for nausea and vomiting of pregnancy: a randomized, double-blind placebo-controlled study.  Obstet Gynecol. 1991;  78 33-36
    PubMedGoogle Scholar
  • 81 Vutyavanich T, Wongtra-ngan S, Ruangsri R. Pyridoxine for nausea and vomiting of pregnancy: a randomized, double-blind, placebo-controlled trial.  Am J Obstet Gynecol. 1995;  173 (3 Pt 1) 881-884
    CrossrefPubMedGoogle Scholar
  • 82 Chiossi G, Neri I, Cavazzuti M et al. Hyperemesis gravidarum complicated by Wernicke encephalopathy: background, case report, and review of the literature.  Obstet Gynecol Surv. 2006;  61 255-268
    CrossrefPubMedGoogle Scholar
  • 83 Kallen B, Lundberg G, Aberg A. Relationship between vitamin use, smoking, and nausea and vomiting of pregnancy.  Acta Obstet Gynecol Scand. 2003;  82 916-920
    CrossrefPubMedGoogle Scholar
  • 84 Bühling K J. Nausea and Hyperemesis gravidarum.  Gynäkol Geburtsmed Gynakol Endokrinol. 2008;  4 36-48
    PubMedGoogle Scholar
  • 85 Mazzotta P, Magee L A. A risk-benefit assessment of pharmacological and nonpharmacological treatments for nausea and vomiting of pregnancy.  Drugs. 2000;  59 781-800
    CrossrefPubMedGoogle Scholar
  • 86 Leathem A M. Safety and efficacy of antiemetics used to treat nausea and vomiting in pregnancy.  Clin Pharm. 1986;  5 660-668
    PubMedGoogle Scholar
  • 87 Koren G, Levichek Z. The teratogenicity of drugs for nausea and vomiting of pregnancy: perceived versus true risk.  Am J Obstet Gynecol. 2002;  186 (5 Suppl. Understanding) S248-S252
    CrossrefPubMedGoogle Scholar
  • 88 Magee L A, 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
    CrossrefPubMedGoogle Scholar
  • 89 Rohde A, Dembinski J, Dorn C. Mirtazapine (Remergil) for treatment resistant hyperemesis gravidarum: rescue of a twin pregnancy.  Arch Gynecol Obstet. 2003;  268 219-221
    CrossrefPubMedGoogle Scholar
  • 90 Lacasse A, Lagoutte A, Ferreira E et al. Metoclopramide and diphenhydramine in the treatment of hyperemesis gravidarum: effectiveness and predictors of rehospitalisation.  Eur J Obstet Gynecol Reprod Biol. 2009;  143 43-49
    CrossrefPubMedGoogle Scholar
  • 91 Yoon C K, Chang M H, Lee D C. Wernicke-Korsakoff syndrome associated with hyperemesis gravidarum.  Korean J Ophthalmol. 2005;  19 239-242
    CrossrefPubMedGoogle Scholar
  • 92 Arsenault M Y, Lane C A, MacKinnon C J et al. The management of nausea and vomiting of pregnancy.  J Obstet Gynaecol Can. 2002;  24 817-831 quiz 832-833
    PubMedGoogle Scholar
  • 93 Ditto A, Morgante G, la Marca A et al. Evaluation of treatment of hyperemesis gravidarum using parenteral fluid with or without diazepam. A randomized study.  Gynecol Obstet Invest. 1999;  48 232-236
    CrossrefPubMedGoogle Scholar
  • 94 Tasci Y, Demir B, Dilbaz S et al. Use of diazepam for hyperemesis gravidarum.  J Matern Fetal Neonatal Med. 2009;  22 353-356
    CrossrefPubMedGoogle Scholar
  • 95 Lagiou P, Tamimi R, Mucci L A et al. Nausea and vomiting in pregnancy in relation to prolactin, estrogens, and progesterone: a prospective study.  Obstet Gynecol. 2003;  101 639-644
    CrossrefPubMedGoogle Scholar
  • 96 Park-Wyllie L, Mazzotta P, Pastuszak A et al. Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies.  Teratology. 2000;  62 385-392
    CrossrefPubMedGoogle Scholar
  • 97 Bondok R S, El Sharnoubi N M, Eid H E et al. Pulsed steroid therapy is an effective treatment for intractable hyperemesis gravidarum.  Crit Care Med. 2006;  34 2781-2783
    CrossrefPubMedGoogle Scholar
  • 98 Vaisman N, Kaidar R, Levin I et al. Nasojejunal feeding in hyperemesis gravidarum – a preliminary study.  Clin Nutr. 2004;  23 53-57
    CrossrefPubMedGoogle Scholar
  • 99 Ghani R. The use of total parenteral nutrition in protracted hyperemesis gravidarum.  J Obstet Gynaecol. 2003;  23 199-201
    PubMedGoogle Scholar
  • 100 Stanga Z, Brunner A, Leuenberger M et al. Nutrition in clinical practice – the refeeding syndrome: illustrative cases and guidelines for prevention and treatment.  Eur J Clin Nutr. 2008;  62 687-694
    CrossrefPubMedGoogle Scholar
  • 101 Biesalski H K, Bischoff S C, Böhles H-J et al. Wasser, Elektrolyte, Vitamine und Spurenelemente.  Aktuel Ernahrungsmed. 2007;  32 30-34
    Article in Thieme ConnectPubMedGoogle Scholar
  • 102 Hytten F E. Nutrition.. In: Hytten F E, Chamberlain G, eds. Clinical Physiology in Obstetrics.. London: Blackwell; 1991: 153
    Google Scholar
  • 103 Bung P. Schwangerschaft und Ernährung.. In: Schneider H, Husslein P, Schneider K TM, Hrsg. Die Geburtshilfe.. Berlin: Springer; 2006: 219-234
    Google Scholar
  • 104 Kreymann G, Adolph M, Müller M J. Energieumsatz und Energiezufuhr.  Aktuel Ernahrungsmed. 2007;  32 8-12
    Article in Thieme ConnectPubMedGoogle Scholar
  • 105 National Collaborating Centre for Acute Care .NICE – Nutrition support in adults. Oral nutrition support, enteral tube feeding and parenteral nutrition.. London: National Collaborating Centre for Acute Care at The Royal College of Surgeons of England; 2006
    Google Scholar
  • 106 Mazzotta P, Stewart D E, Koren G et al. Factors associated with elective termination of pregnancy among Canadian and American women with nausea and vomiting of pregnancy.  J Psychosom Obstet Gynaecol. 2001;  22 7-12
    CrossrefPubMedGoogle Scholar
  • 107 Poursharif B, Korst L M, Macgibbon K W et al. Elective pregnancy termination in a large cohort of women with hyperemesis gravidarum.  Contraception. 2007;  76 451-455
    CrossrefPubMedGoogle Scholar
  • 108 Poursharif B, Korst L M, Fejzo M S et al. The psychosocial burden of hyperemesis gravidarum.  J Perinatol. 2008;  28 176-181
    CrossrefPubMedGoogle Scholar
  • 109 Munch S, Schmitz M F. The Hyperemesis Beliefs Scale (HBS): a new instrument for assessing beliefs about severe nausea and vomiting in pregnancy.  J Psychosom Obstet Gynaecol. 2007;  28 219-229
    CrossrefPubMedGoogle Scholar
  • 110 Power Z, Campbell M, Kilcoyne P et al. The Hyperemesis Impact of Symptoms Questionnaire: development and validation of a clinical tool.  Int J Nurs Stud. 2010;  47 67-77
    CrossrefPubMedGoogle Scholar
  • 111 Goodwin T M. Nausea and vomiting of pregnancy: an obstetric syndrome.  Am J Obstet Gynecol. 2002;  186 (5 Suppl. Understanding) S184-S189
    CrossrefPubMedGoogle Scholar

Dr. Harald Abele

Perinatalzentrum Universitätsklinikum Tübingen
Universitäts-Frauenklinik

Calwer Straße 7

72076 Tübingen

Email: harald.abele@med.uni-tuebingen.de

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