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Archives of Gynecology and Obstetrics Nov 2022To evaluate the burden of illness caused by hyperemesis gravidarum (HG) and association of readmissions due to HG with maternal, environmental and pregnancy-related...
PURPOSE
To evaluate the burden of illness caused by hyperemesis gravidarum (HG) and association of readmissions due to HG with maternal, environmental and pregnancy-related factors, and different pregnancy outcomes.
METHODS
Data of women with HG diagnosis in Finland, 2005-2017, were retrieved from health-care registers. Associations between readmissions due to HG and age, gravidity, parity, pre-pregnancy body mass index (BMI), smoking, marital status, socioeconomic status, municipality population, assisted reproductive technology (ART), and number and sex of fetuses were analyzed in pregnancies resulting in delivery. Admissions and readmissions due to HG in deliveries, gestational trophoblastic disease, ectopic pregnancies, miscarriages and pregnancy terminations were calculated.
RESULTS
10,381 pregnancies with HG diagnosis were identified: 9518 live births, 31 stillbirths, 8 cases of gestational trophoblastic disease, 16 ectopic pregnancies, 299 miscarriages, and 509 pregnancy terminations. Both outpatients and inpatients were included. Readmission occurred in 60% of pregnancies, inpatient readmission in 17%. Parity of ≥ 5, multiple gestation and female sex of fetus were associated with higher odds of readmission, maternal age 36-40 years, BMI ≥ 35 kg/m, smoking and ART with lower odds of readmission. Of the 9549 pregnancies resulting in delivery, 33% involved at least one outpatient visit or inpatient episode after the first trimester, and 8% in the third trimester.
CONCLUSION
The majority of women suffering from HG needed repeated medical care, often persisting after the first trimester. Our results provide practical information allowing clinicians to prepare for symptom duration beyond the first trimester and emphasize the importance of planning for eventual long-term treatment.
Topics: Abortion, Spontaneous; Adult; Female; Finland; Gestational Trophoblastic Disease; Humans; Hyperemesis Gravidarum; Patient Readmission; Pregnancy; Pregnancy, Ectopic
PubMed: 35226159
DOI: 10.1007/s00404-022-06448-w -
BJOG : An International Journal of... Oct 2022Whole‐exome sequencing reveals placenta and vomiting hormone GDF15 most likely cause of Hyperemesis Gravidarum.
Whole‐exome sequencing reveals placenta and vomiting hormone GDF15 most likely cause of Hyperemesis Gravidarum.
Topics: Female; Humans; Pregnancy; Growth Differentiation Factor 15; Hyperemesis Gravidarum; Nausea; Exome Sequencing
PubMed: 35218128
DOI: 10.1111/1471-0528.17129 -
The British Journal of Nutrition Dec 2022This study aimed to investigate the association between hyperemesis gravidarum (HG) severity and early enteral tube feeding on cardiometabolic markers in offspring cord...
This study aimed to investigate the association between hyperemesis gravidarum (HG) severity and early enteral tube feeding on cardiometabolic markers in offspring cord blood. We included women admitted for HG, who participated in the MOTHER randomised controlled trial (RCT) and observational cohort. The MOTHER RCT showed that early enteral tube feeding in addition to standard care did not affect symptoms/birth outcomes. Among RCT and cohort participants, we assessed how HG severity affected lipid, c-peptide, glucose and free thyroxine cord blood levels. HG severity measures were severity of vomiting at inclusion and 3 weeks after inclusion, pregnancy weight gain and 24-h energy intake at inclusion, readmissions and duration of hospital admissions. Cord blood measures were also compared between RCT participants allocated to enteral tube feeding and those receiving standard care. Between 2013-2016, 215 women were included: 115 RCT and 100 cohort participants. Eighty-one cord blood samples were available. Univariable not multivariable regression analysis showed that lower maternal weight gain was associated with higher cord blood glucose levels (: -0·08, 95% CI -0·16, -0·00). Lower maternal weight gain was associated with higher Apo-B cord blood levels in multivariable regression analysis (: -0·01, 95% CI -0·02, -0·01). No associations were found between other HG severity measures or allocation to enteral tube feeding and cord blood cardiometabolic markers. In conclusion, while lower maternal weight gain was associated with higher Apo-B cord blood levels, no other HG severity measures were linked with cord blood cardiometabolic markers, nor were these markers affected by enteral tube feeding.
Topics: Pregnancy; Female; Humans; Enteral Nutrition; Hyperemesis Gravidarum; Gestational Weight Gain; Fetal Blood; Cardiovascular Diseases
PubMed: 35197140
DOI: 10.1017/S0007114522000587 -
The Pan African Medical Journal 2021Wernicke encephalopathy is a potentially life-threatening neurologic syndrome caused by acute thiamine (vitamin B1) deficiency. It is usually associated with excessive...
Wernicke encephalopathy is a potentially life-threatening neurologic syndrome caused by acute thiamine (vitamin B1) deficiency. It is usually associated with excessive alcohol consumption. Less frequently, this syndrome can be caused by persistent vomiting. This is a case report of a 33-year-old woman diagnosed with Wernicke encephalopathy (WE) during the second trimester of pregnancy. The presence of neurological and ophthalmological symptoms in the context of hyperemesis gravidarum led us to evoke the diagnosis of WE, and it was confirmed when specific lesions were found in the brain magnetic resonance imaging (MRI). Luckily for our patient, WE was diagnosed promptly and the signs were reversible after thiamine supplementation. In conclusion, any first line care taker or midwife must know the symptoms of Wernicke encephalopathy because prompt diagnosis and treatment can lead to recovery.
Topics: Adult; Female; Humans; Hyperemesis Gravidarum; Magnetic Resonance Imaging; Pregnancy; Pregnancy Trimester, Second; Thiamine; Thiamine Deficiency; Wernicke Encephalopathy
PubMed: 35178151
DOI: 10.11604/pamj.2021.40.240.30245 -
Physiological Reports Feb 2022The impact of acute mountain sickness (AMS) and sleep disturbances on mood and cognition at two altitudes relevant to the working and tourist population is unknown....
The impact of acute mountain sickness (AMS) and sleep disturbances on mood and cognition at two altitudes relevant to the working and tourist population is unknown. Twenty unacclimatized lowlanders were exposed to either 3000 m (n = 10; 526 mmHg) or 4050 m (n = 10; 460 mmHg) for 20 h in a hypobaric chamber. AMS prevalence and severity was assessed using the Environmental Symptoms Questionnaire (ESQ) and an AMS-C score ≥ 0.7 indicated sickness. While sleeping for one night both at sea level (SL) and high altitude (HA), a wrist motion detector was used to measure awakenings (Awak, events/h) and sleep efficiency (Eff, %). If Eff was ≥85%, individuals were considered a good sleeper (Sleep+). Mood and cognition were assessed using the Automated Neuropsychological Assessment Metric and Mood Scale (ANAM-MS). The ESQ and ANAM-MS were administered in the morning both at SL and after 20 h at HA. AMS severity (mean ± SE; 1.82 ± 0.27 vs. 0.20 ± 0.27), AMS prevalence (90% vs. 10%), depression (0.63 ± 0.23 vs. 0.00 ± 0.24) Awak (15.6 ± 1.6 vs. 10.1 ± 1.6 events/h), and DeSHr (38.5 ± 6.3 vs. 13.3 ± 6.3 events/h) were greater (p < 0.05) and Eff was lower (69.9 ± 5.3% vs. 87.0 ± 5.3%) at 4050 m compared to 3000 m, respectively. AMS presence did not impact cognition but fatigue (2.17 ± 0.37 vs. 0.58 ± 0.39), anger (0.65 ± 0.25 vs. 0.02 ± 0.26), depression (0.63 ± 0.23 vs. 0.00 ± 0.24) and sleepiness (4.8 ± 0.4 vs. 2.7 ± 0.5) were greater (p < 0.05) in the AMS+ group. The Sleep- group, compared to the Sleep+ group, had lower (p < 0.05) working memory scores (50 ± 7 vs. 78 ± 9) assessed by the Sternberg 6-letter memory task, and lower reaction time fatigue scores (157 ± 17 vs. 221 ± 22), assessed by the repeated reaction time test. Overall, AMS, depression, DeSHr, and Awak were increased (p < 0.05) at 4050 m compared to 3000 m. In addition, AMS presence impacted mood while poor sleep impacted cognition which may deteriorate teamwork and/or increase errors in judgement at HA.
Topics: Acclimatization; Affect; Altitude Sickness; Cognition; Female; Humans; Male; Sleep Wake Disorders; Young Adult
PubMed: 35133088
DOI: 10.14814/phy2.15175 -
Pharmaceutics Jan 2022Since the teratogenicity of Thalidomide has been proven, herbal products are more commonly used in pregnancy to not only relieve morning sickness but also to fight... (Review)
Review
Since the teratogenicity of Thalidomide has been proven, herbal products are more commonly used in pregnancy to not only relieve morning sickness but also to fight infections. These products are frequently considered as natural and therefore harmless. However, herbs contain a number of active substances that, when used during pregnancy, can affect the development of the fetus. Often, pregnant women do not consult the usage of herbal medicines with a physician. The access to these products is easy and treatment of certain ailments with the use of herbs is common in many countries. The aim of the present literature review was to discuss available data regarding the efficacy and safety of cranberry, chamomile, , garlic, ginger, , and peppermint, which are used to counteract the most common ailments during pregnancy, i.e., infections and pregnancy-related ailments (e.g., nausea and vomiting, dizziness, and headache). Analysis of available data showed that ginger is one of the most extensively analyzed herbal remedies. The dose of ginger below 1000 mg per day may help to relief , and such an amount of ginger did not increase frequency of adverse effects for either woman or developing fetus. Data regarding other herbs are most often heterogeneous and give conflicting results with no clear conclusions. However, all herbal products should be used with a special caution in pregnancy. Further high-quality human studies should be determined to confirm the safe doses of herbal products which could be used by pregnant or breast-feeding women.
PubMed: 35057067
DOI: 10.3390/pharmaceutics14010171 -
BMJ Case Reports Jan 2022A fit and healthy 44-year-old woman took a single dose of oral acetazolamide (125 mg) in preparation for a hiking trip to Everest base camp. She awoke the next morning...
A fit and healthy 44-year-old woman took a single dose of oral acetazolamide (125 mg) in preparation for a hiking trip to Everest base camp. She awoke the next morning with profoundly blurred distance vision. She presented to eye casualty later that morning, approximately 18 hours postingestion: examination demonstrated myopia and bilateral choroidal effusions. Acetazolamide is used to minimise symptoms of altitude sickness. Rarely, its use can be linked with ophthalmic side effects, such as myopia. A handful of case reports also describe choroidal effusions secondary to its use as part of ophthalmic treatment (eg, postoperatively). This is the first reported case in which choroidal effusions have been demonstrated as a side effect of its prophylactic use against altitude sickness.
Topics: Acetazolamide; Adult; Altitude; Altitude Sickness; Choroidal Effusions; Female; Humans; Mountaineering; Myopia
PubMed: 35039358
DOI: 10.1136/bcr-2021-246145 -
Maternal and Child Health Journal Feb 2022Syndemic theory posits that poor health outcomes co-occur and amplify each other in the context of harmful conditions that must be addressed simultaneously to improve...
INTRODUCTION
Syndemic theory posits that poor health outcomes co-occur and amplify each other in the context of harmful conditions that must be addressed simultaneously to improve health equity. This analysis identifies perinatal syndemic factors and examine how factors are related to STI in a sample of racially diverse young pregnant women.
METHODS
Pregnant participants (n = 61) ages 14-21 from racially diverse backgrounds were recruited from a prenatal clinic for an ongoing longitudinal study between October 2019-February 2020. Participants completed a tablet survey assessing pregnancy intention, psychosocial factors (e.g., depression, stress, partner violence, pregnancy history) and consented to provide access to their medical records for STI and clinical urine samples screened for tobacco and cannabis use. Latent class analysis (LCA) was used to examine probabilities of co-occurring Syndemic indicators.
RESULTS
Half of the women were Black (52%) and primigravida (54%). Three classes were identified in the LCA, two of them reflecting syndemics related to STI from the medical record. The largest class was half Black (51%), with a high rate of STI (65%), and was characterized by factors including depressive symptoms (93%), stress (64%), and substance use (65% cannabis, 82% tobacco). Additionally, the class with the highest rates of STI (74%) also had higher rates of partner violence (48%), morning sickness (100%), and prenatal cannabis use (63%).
CONCLUSION
Findings indicate evidence of a syndemic related to increased STI. A longitudinal evaluation of syndemics in this cohort may inform appropriately tailored intervention strategies to promote perinatal health in racially diverse young pregnant populations.
Topics: Adolescent; Adult; Female; HIV Infections; Humans; Longitudinal Studies; Pregnancy; Pregnant Women; Sexual Behavior; Sexually Transmitted Diseases; Substance-Related Disorders; Syndemic; Young Adult
PubMed: 34993752
DOI: 10.1007/s10995-021-03335-9 -
Gaceta Sanitaria 2021This study aimed to determine the relationship between eating habits and hyperemesis gravidarum with preeclampsia incidence.
OBJECTIVE
This study aimed to determine the relationship between eating habits and hyperemesis gravidarum with preeclampsia incidence.
METHOD
This study used a cross-sectional design. The total sample was 48 pregnant women with normal and preeclamptic pregnancies who had a gestational age above 20 weeks, collecting data using a questionnaire and data analysis using the chi-square test and odds ratio (OR).
RESULTS
The habit of eating irregular fruit during pregnancy was significantly associated with the incidence of preeclampsia, with an OR value of 8.57. Mothers who had hyperemesis gravidarum increased their risk 3.86 times for developing preeclampsia.
CONCLUSION
Eating habits and history of hyperemesis gravidarum is a risk factor of preeclampsia. Nutritional intervention is needed through nutrition education for pre-pregnant women so that their nutritional adequacy during pregnancy can be fulfilled, especially during the 1st trimester, namely the implantation phase and socialization of the community movement program for healthy living, especially the consumption of vegetables and fruits for women of childbearing age, women during pre-pregnancy, pregnant and breastfeeding.
Topics: Cross-Sectional Studies; Feeding Behavior; Female; Humans; Hyperemesis Gravidarum; Infant; Pre-Eclampsia; Pregnancy; Risk Factors
PubMed: 34929886
DOI: 10.1016/j.gaceta.2021.10.080 -
Prague Medical Report 2021This study is aimed at determination whether pregnant women who develop hyperemesis gravidarum in the first trimester have a tendency to develop gestational diabetes...
This study is aimed at determination whether pregnant women who develop hyperemesis gravidarum in the first trimester have a tendency to develop gestational diabetes mellitus (GDM). It is also aimed at identification of effects of hyperemesis gravidarum and GDM on prenatal and neonatal status in case they were detected together. Hyperemesis gravidarum diagnose was based on the following signs and symptoms. To diagnose GDM, first trimester fasting blood glucose measurement and subsequent blood glucose monitoring and 75-g oral glucose tolerance test (OGTT) were performed in the second trimester. A total of 949 singleton pregnant women (95 with and 852 without hyperemesis gravidarum) who met our criteria were included in the study. In the first trimester, plasma blood glucose and positive GDM screening were found to be significantly higher in the hyperemesis gravidarum group compared to the control group (p=0.042 and p<0.001, respectively). However, actual GDM cases were similar between both groups. The positive predictive value was significantly lower in the hyperemesis gravidarum group (28.5% vs. 72.7%, p=0.003). In the second trimester, the prevalence of GDM was 6.6% in the hyperemesis gravidarum group and 7.3% in the control group, with no significant difference (p=0.218) between-groups. In this study, hyperemesis gravidarum was found to cause changes in maternal metabolism in the first trimester of pregnancy due to limited calorie intake and fasting; in the presence of hyperemesis gravidarum, it should be known that the positive predictive value of first trimester gestational diabetes screening may decrease and the diagnosis of pseudo-GDM may increase.
Topics: Blood Glucose; Blood Glucose Self-Monitoring; Diabetes, Gestational; Female; Glucose Tolerance Test; Humans; Hyperemesis Gravidarum; Infant, Newborn; Pregnancy
PubMed: 34924106
DOI: 10.14712/23362936.2021.26