Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00000009.xml
Download PDF
Am J Perinatol 2000; Volume 17(Number 04): 207-218
DOI: 10.1055/s-2000-9424
DOI: 10.1055/s-2000-9424
HYPEREMESIS GRAVIDARUM: A CURRENT REVIEW
Further Information
Publication History
Publication Date:
31 December 2000 (online)
ABSTRACT
Hyperemesis gravidarum or pernicious vomiting of pregnancy affects between 0.3% and 2% of all pregnant patients. The objective of this paper is to review current literature pertaining to epidemiology, etiology, symptomatology, complications, treatment, and perinatal outcome of patients with hyperemesis gravidarum. We performed a MEDLINE search of the English literature from 1966 through January 2000 utilizing the keywords: hyperemesis gravidarum, nausea and vomiting, and pregnancy. Current data pertaining to epidemiology, etiology, clinical manifestations, differential diagnosis, complications, various treatment modalities, subsequent perinatal outcome and recent developments are presented. Review of the literature supports that hyperemesis gravidarum is a multifactorial disease in which pregnancy-induced hormonal changes associated with concurrent gastrointestinal dysmotility and possible Helicobacter pylori infection function as contributing factors. Therapeutic key elements are mainly supportive in conjunction with antiemetic medication. It appears perinatal outcome is unaffected.
KEYWORD
Hyperemesis gravidarum - pernicious vomiting - nausea - pregnancy
REFERENCES
- 1 Broussard C N, Richter J E. Nausea and vomiting of pregnancy. Gastroenterol Clin North Am . 1998; 27 123-151
- 2 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
- 3 Fairweather D V. Nausea and vomiting in pregnancy. Am J Obstet Gynecol . 1968; 102 135-137
- 4 Cruikshank D P, Wigton T R, Hays P M. Maternal physiology in pregnancy. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics Normal and Problem Pregnancies
3rd ed. New York: Churchill Livingstone, Inc 1996: 91-109
MissingFormLabel
- 5 Kallen B. Hyperemesis during pregnancy and delivery outcome: a registry study. Eur J Obstet Gynecol Reprod Biol . 1987; 26 292-302
- 6 Bashiri A, Newmann L, Maymon E, Katz M. Hyperemesis gravidarum: epidemiologic features, complications and outcome. Eur J Obstet Gynecol Reprod Biol . 1995; 63 135-138
- 7 Pokras R. Vital and Health Statistics: Detailed Diagnoses and Procedures, National hospital
Discharge Survey. DHHS Pub. No. (PHS) 87-1751
Series 13, No 90 Rockville, MD: US Department of Health and Human Services; 1985
MissingFormLabel
- 8 Commission on Professional and Hospital Activities. Length of Stay by Diagnosis, Northeastern Region
Ann Arbour, MI: CPH Publications 1986: 150
MissingFormLabel
- 9 Klebanoff M A, Koslowe P A, Kaslow R, Rhodes G G. Epidemiology of vomiting in early pregnancy. Obstet Gynecol . 1985; 66 612-616
- 10 Price A, Davies R, Heller S R, Milford-Ward A, Weetman A P. Asian women are at risk of gestational thyrotoxicosis. J Clin Endocrinol Metab . 1996; 81 1160-1163
- 11 Jordan V, MacDonald J, Crichton S, Stone P, Ford H. The incidence of hyperemesis gravidarum is increased among Pacific Islanders living in Wellington. NZ Med J . 1995; 108 342-344
- 12 Depue R H, Bernstein L, Ross R K, Judd H L, Henderson B E. Hyperemesis gravidarum in relation to estradiol levels, pregnancy outcome, and other maternal factors: a seroepidemiology study. Am J Obstet Gynecol . 1987; 156 1137-1141
- 13 Abell T L, Riel C A. Hyperemsis gravidarum. Gastroenterol Clin North Am . 1992; 21 835-849
- 14 Soules M R, Hughes C L, Garcia J A. Nausea and vomiting in pregnancy: role of human chorionic gonadotropin and 17 hydroxyprogesterone. Obstet Gynecol . 1980; 55 696-700
- 15 Goodwin T M, Hershman J M, Cole L. Increased concentration of the free beta-subunit of human chorionic gonadotropin in hyperemesis gravidarum. Acta Obstet Gynecol Scand . 1994; 73 770-772
- 16 Kimura M, Amino N, Tamaki H, Ito E, Mitsuda N, Miyai K, Tanizawa O. Gestational thyrotoxicosis and hyperemesis gravidarum: role of hCG with higher stimulating activity. Clin Endocrinol . 1993; 38 345-350
- 17 Jordan V, Grebe S KG, Cooke R R. Acidic forms of chorionic gonadotropin in European and Samoan women are associated with hyperemesis gravidarum and may be thyrotropic. Clin Endocrinol . 1999; 50 619-627
- 18 Kennedy R L, Darne J, Davies R, Price A. Thyrotoxicosis and hyperemesis gravidarum associated with a serum activity which stimulates human thyroid cells in vitro. Clin Endocrinol . 1992; 36 83-89
- 19 Mestman J H. Hyperthyroidism in pregnancy. Endocrin Metab Clin North Am . 1998; 27 127-149
- 20 Boullion R, Naesens M, van Assche F A. Thyroid function in patients with hyperemesis gravidarum. Am J Obstet Gynecol . 1982; 143 922-926
- 21 Bober S A, McGill A C, Tunbridge W MG. The thyroid function in hyperemesis gravidarum. Acta Endocrinol . 1986; 111 404-410
- 22 Valbo A, Jerve F. A study of thyroid hormones in women suffering from vomiting in pregnancy. Acta Eur Fertil . 1987; 18 381-383
- 23 Wilson R, McKillop J H, MacLean M. Thyroid function test are rarely abnormal in patients with severe hyperemesis gravidarum. Clin Endocrinol . 1992; 37 331-334
- 24 Goodwin T M, Montoro M, Mestman J H. Transient hyperthyroidism and hyperemesis gravidarum: clinical aspects. Am J Obstet Gynecol . 1992; 167 649-652
- 25 Goodwin T M, Montoro M, Mestman J H, Pekary A E, Hershman J M. The role of chorionic gonadotropin in transient hyperthyroidism of hyperemesis gravidarum. J Clin Endocrinol Metab . 1992; 75 1333-1337
- 26 Sullivan C A, Johnson C A, Roach H, Martin R W, Stewart D K, Morrison J C. A pilot study of intravenous ondansteron for hyperemesis gravidarum. Am J Obstet Gynecol . 1996; 174 1565-1568
- 27 Hasler W L. Serotonin receptor physiology: relation to emesis. Dig Dis Sci . 1999; 44 108S-118S
- 28 Guikontes E, Spantideas A, Diakadis J. Ondansterone and hyperemesis gravidarum. Lancet . 1992; 340 1223
- 29 World M J. Ondansterone and hyperemesis gravidarum. Lancet . 1993; 341 185
- 30 Borgeat A, Fathi M, Valiton A. Hyperemesis gravidarum: is serotonin implicated. Am J Obstet Gynecol . 1997; 176 476-477
- 31 Van Thiel D H, Gravaler J S, Joshi S N. Heartburn of pregnancy. Gastroenterol . 1977; 72 666-668
- 32 Koch K l, Stern R M, Vasey M, Otti J J, Creasy G W, Dwyer A. Gastric dysrhythmias and nausea of pregnancy. Digestive Diseases and Sciences . 1990; 35 961-968
- 33 Riezzo G, Pezzolla F, Darconza G, Giorgio I. Gastric myoelectrical activity in the first trimester of pregnancy: a cutaneous electrogastrographic study. Am J Gastroenterol . 1992; 87 702-707
- 34 Maes B D, Spitz B, Ghoos Y F, Hiele M I, Evenepoel P, Rutgeerts. Gastric emptying in hyperemesis gravidarum and non-dyspeptic pregnancy. Aliment Pharmacol Ther . 1999; 13 237-243
- 35 Michaletz-Onody P A. Peptic ulcer disease in pregnancy. Gastroenterol Clin North Am . 1992; 21 817-826
- 36 Frigo P, Lang C, Reisenberger K, Hirschl A M. Hyperemesis gravidarum associated with Helicobacter pylori Seropositivity. Obstet Gynecol . 1998; 91 615-617
- 37 El Younis C M, Abulafia O, Sherer D M. Rapid response of severe hyperemesis gravidarum to oral erythromycin. Am J Perinatol . 1998; 15 533-534
- 38 Jacoby E B, Porter K B. Helicobacter Pylori infection and persistent hyperemesis gravidarum. Am J Perinatol . 1999; 16 85-88
- 39 Morali J A, Braverman D Z. Abnormal liver enzymes and ketonuria in hyperemesis gravidarum: a retrospective review of eighty patients. J Clin Gastroenterol . 1990; 12 303-305
- 40 Wallstedt A, Riely C A, Shaver D. Prevalence and characteristics of liver dysfunction in hyperemesis gravidarum. Clin Res . 1990; 38 970-972
- 41 Larrey D, Rueff B, Feldman G, Degott C, Danan G, Benhamou J P. Recurrent jaundice caused by recurrent hyperemesis gravidarum. Gut . 1984; 25 1414-1415
- 42 Orazi G, Dufour P H, Puech F. Jaundice induced by hyperemesis gravidarum. Int J Gynecol Obstet . 1998; 61 181-183
- 43 Signorello L B, Harlow B L, Wang S, Erick M A. Saturated fat intake and the risk of severe hyperemesis gravidarum. Epidemiology . 1998; 9 636-640
- 44 Minagawa M, Narita J, Tada T. Mechanisms underlying immunologic states during pregnancy: possible association of the sympathetic nervous system. Cell Immunol . 1999; 196 1-13
- 45 Reinken L, Gant H. Vitamin B6 nutrition in women with hyperemesis gravidarum during the first trimester of pregnancy. Clin Chim Acta . 1974; 55 101-102
- 46 Tabbakh G E, Darwish E, Sebaie F E. Study of serum copper and zinc in serum of patients with hyperemesis gravidarum. Int J Gynecol Obstet . 1989; 29 207-212
- 47 Lao T T, Chin R KH, Mak Y T, Panesar N S. Plasma zinc concentration and thyroid function in hyperemetic pregnancies. Acta Obstet Gynecol Scand . 1988; 67 599-604
- 48 Chin R KH, Lao T T, Swaminathan R, Mak Y T. A longitudinal study of changes in erythrocyte zinc concentration in hyperemesis gravidarum. Gynecol Obstet Invest . 1990; 29 22-25
- 49 Guze B, DeLong W B, Majerus P W. Association of clinical psychiatric disease with hyperemesis gravidarum. N Engl J Med . 1957; 261 136-138
- 50 Katon W J, Ries R K, Bokan L A. Hyperemesis gravidarum: a biopsychological perspective. Int J Psychiatry Med . 1980; 10 151-162
- 51 Iancu I, Kotler M, Spivak B, Radvan M, Weizman A. Psychiatric aspects of hyperemesis gravidarum. Psychother Psychosome . 1994; 61 143-149
- 52 Stewart D E. Reproductive functions in eating disorders. Ann Med . 1992; 24 287-291
- 53 Lingham R, McCluskey S. Eating disorders associated with hyperemesis gravidarum. J Psychosomatic Res . 1996; 40 231-234
- 54 Johnson D R, Douglas D, Hauswald M, Tandberg D. Dehydration and orthostatic vital signs in women with hyperemesis gravidarum. Acad Emerg Med . 1995; 2 692-697
- 55 Hod M, Orvieto R, Kaplan B, Friedman S, Ovadia J. Hyperemesis gravidarum: a review. J Reprod Med . 1994; 39 605-612
- 56 Goodwin T M. Hyperemesis gravidarum. Clin Obstet Gynecol . 1998; 41 597-605
- 57 Robertson C, Millar H. Hyperamylasemia in bulimia nervosa and hyperemesis gravidarum. Int J Eat Disorder . 1999; 26 223-227
- 58 Omer S M, al Kawi M Z, al Watban J, Bohelga S, McLean D R, Miller G. Acute Wernicke's encephalopathy associated with hyperemesis gravidarum: magnetic resonance imaging findings. J Neuroimaging . 1995; 5 251-253
- 59 Rotman P, Hassin D, Mouallem M, Barkai G, Farfel Z. Wernicke's encephalopathy in hyperemesis gravidarum: association with abnormal liver function. Isr J Med Sci . 1994; 30 225-228
- 60 Gardian G, Voros E, Jardanhazy T, Ungurean A, Vecsei L. Wernicke's encephalopathy induced by hyperemesis gravidarum. Acta Neurol Scand . 1999; 99 196-198
- 61 Rees J H, Ginsberg L, Schapira H V. Two pregnant women with vomiting and fits. Am J Obstet Gynecol . 1997; 177 1539-1540
- 62 Ohkoshi N, Ishii A, Shoji S. Wernicke's encephalopathy induced by hyperemesis gravidarum, associated with bilateral caudate lesions on computed tomography and magnetic resonance imaging. Eur Neurol . 1994; 34 177-180
- 63 Peeters A, van de wyngaert F, Van Lierde M, Sindic C J, Laterre E C. Wernicke's encephalopathy and central pontine myelinolysis induced by hyperemesis gravidarum. Acta Neurol Belg . 1993; 93 276-282
- 64 Bergin P S, Harvey P. Wernicke's encephalopathy and central pontine myelinolysis associated with hyperemesis gravidarum. Br Med J . 1992; 305 517-518
- 65 Castillo R A, Ray R A, Yaghmai F. Central pontine myelinolysis and pregnancy. Obstet Gynecol . 1989; 73 459-461
- 66 Fraser D. Central pontine myelinolysis as a result of treatment of hyperemesis gravidarum: case report. Br J Obstet Gynaecol . 1988; 95 621-623
- 67 Arieff A I. Hyponatremia, convulsions, respiratory arrest and permanent brain damage after elective surgery in healthy women. N Engl J Med . 1986; 314 1529-1534
- 68 Kanayama N, Khatun S, Belayet H M. Vasospasms of cerebral arteries in hyperemesis gravidarum. Gynecol Obstet Invest . 1998; 46 139-141
- 69 Schwartz M, Rossoff L. Pneumomediastinum and bilateral pneumothoraces in a patient with hyperemesis gravidarum. Chest . 1994; 106 1904-1906
- 70 Gorbach J S, Counselmann F L, Mendelson M H. Spontaneous pneumomediastinum secondary to hyperemesis gravidarum. J Emerg Med . 1997; 15 639-643
- 71 Chirino O, Kovac R, Bale D, Blythe J G. Barogenic rupture of the esophagus associated with hyperemesis gravidarum. Obstet Gynecol . 1978; 52 51S-53S
- 72 Fukada Y, Ohta S, Mizuno K, Hoshi K. Rhabdomyolysis secondary to hyperemesis gravidarum. Acta Obstet Gynecol Scand . 1999; 78 71-73
- 73 Robinson J N, Banerjee R, Thiet M P. Coagulopathy secondary to vitamin K deficiency in hyperemesis gravidarum. Obstet Gynecol . 1998; 92 673-675
- 74 van Stuijvenberg M E, Schabort I, Labadarios D, Nel J T. The nutritional status and treatment of patients with hyperemesis gravidarum. Am J Obstet Gynecol . 1995; 172 1585-1591
- 75 Greenspoon J S, Rosen D J, Ault M. Use of the peripherally inserted central catheter for parenteral nutrition during pregnancy. Obstet Gynecol . 1993; 81 831-834
- 76 Sahakian V, Rouse D, Sipes S. Vitamin B6 is effective therapy for nausea and vomiting of pregnancy: a randomized double blind placebo controlled study. Obstet Gynecol . 1991; 78 33-36
- 77 Nageotte M P, Briggs G G, Towers C V, Asrat T. Droperidol and diphenhydramine in the management of hyperemesis gravidarum. Am J Obstet Gynecol . 1996; 174 1801-1805
- 78 Leathem A. Safety and efficacy of antiemetics used to treat nausea and vomiting of pregnancy. Clin Pharm . 1986; 5 660-668
- 79 Desmond P V, Watson K JR. Metoclorpramide: a review. Med J Aust . 1986; 144 366-369
- 80 Safari H R, Alsulyman O M, Gherman R B, Goodwin T M. Experience with oral methylprednisolone in the treatment of refractory hyperemesis gravidarum. Am J Obstet Gynecol . 1998; 178 1054-1058
- 81 Safari H R, Fassett M J, Souter I C, Alsulyman O M, Goodwin T M. The efficacy of methylprednisolone in the treatment of hyperemesis gravidarum: a randomized, double blind, controlled study. Am J Obstet Gynecol . 1998; 179 921-924
- 82 Fisher-Rasmussen W, Kjaer S, Dahl C, Asping U. Ginger treatment of hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol . 1990; 38 19-24
- 83 Hsu J J, Clark-Glena R, Nelson D K, Kim C H. Nasogastric enteral feeding in the management of hyperemesis gravidarum. Obstet Gynecol . 1996; 88 343-346
- 84 Erick M. Nutrition via jejunostomy in refractory hyperemesis gravidarum: a case report. J Am Diet Assoc . 1997; 97 1154-1156
- 85 Godil A, Chen Y K. Percutaneous endoscopic gastrostomy for nutrition support in pregnancy associated with hyperemesis gravidarum and anorexia nervosa. J Parenter Enter Nutr . 1998; 22 238-241
- 86 Zibell-Frisk D, Jen K L, Rick J. Use of parenteral nutrition to maintain adequate nutritional status in hyperemesis gravidarum. J Perinatol . 1990; 10 390-395
- 87 Naef R W, Chauhan S P, Roach H, Roberts W E, Travis K H, Morrison J C. Treatment for hyperemesis gravidarum in the home: an alternative to hospitalization. J Perinatol . 1995; 15 289-292
- 88 Gross S, Librach C, Cecutti A. Maternal weight loss associated with hyperemesis gravidarum: a predictor of fetal outcome. Am J Obstet Gynecol . 1989; 160 906-909
- 89 Godsey R K, Newman R B. Hyperemesis gravidarum: a comparison of single and multiple admissions. J Reprod Med . 1991; 36 287-290
- 90 Hallak M, Tsalamandris K, Drombrowski M P, Isada N B, Pryde P G, Evans M I. Hyperemesis gravidarum: effects on fetal outcome. J Reprod Med . 1996; 41 871-874
- 91 Tsang I S, Katz V L, Wells S D. Maternal and fetal outcomes in hyperemesis gravidarum. Int J Gynecol Obstet . 1996; 55 231-23