NAUSEA AND VOMITING OF PREGNANCY

FACTS ABOUT PREGNANCY SICKNESS SYMPTOMS THEIR RELATION TO VARIOUS ASPECTS OF WOMEN’S PERSONAL AND OBSTETRIC HISTORIES AND OTHER SIGNIFICANT FACTORS RELATED TO NAUSIA AND VOMITING OF PREGNANCY OR HYPEREMESIS GRAVIDARUM

A LITERATURE REVIEW

R GADSBY
A M BARNIE-ADSHEAD

INTRODUCTION TO A LITERATURE REVIEW OF PREGNANCY SICKNESS

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A. CLINICAL FEATURES OF NAUSEA AND VOMITING OF
PREGNANCY (NVP) AND HYPEREMESIS GRAVIDARUM (HG).
NVP IN ANIMALS.

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Item

  1. Incidence of NVP.
  2. Features of the nausea of NVP (a) Percentage of women with NVP who have nausea only: (b) episodic nature of nausea in pregnancy; (c) regular daily pattern of NVP; (d) severity of nausea; average duration of days of nausea per pregnancy; average duration in hours of nausea per pregnancy. Numbers of women with NVP classified by total hours of nausea; (e) nausea the most distressing symptom of NVP; (f) Hyperemesis Gravidarum develops from NVP; (g) the nausea of NVP is unusual compared to nausea in other
    conditions.

  3. (a) Incidence of vomiting in early pregnancy; (b) severity of vomiting occurring daily; (c) total number of vomits in each woman; (d) significance of vomiting in relation to nausea positive correlation; (e) incidence of vomiting alone without nausea.
  4. Analysis of time of onset of NVP from first day of last menstrual period (LMP) (a) mean day of onset of NVP; (b) early onset of NVP; (c) late onset of NVP; (d) onset of vomiting; (e) time of onset of NVP and HG in relation to their severity; (f) peak time of NVP from LMP.
  5. Cessation of NVP from first day of last period (LMP).
  6. Percentage of women, who deliver a singleton normal infant, who have no NVP.
  7. Time of day of NVP. (a) Exclusively morning or evening; (b) NVP before and after midday; (c) morning sickness is a misnomer; (d) time of day for vomiting in NVP.
  8. (a) Variation of severity of NVP from pregnancy to pregnancy in the same women: (b) symptoms of NVP can recur similarly from one pregnancy to the next in the same women; (c) there is a 50-66% chance symptoms of NVP will be similar in succeeding pregnancies; (d) seven recent papers a higher rate for recurrent HG 70-80% in succeeding pregnancies in the same woman is recorded.
  9. Hyperemesis Gravidarum. (a) Incidence of HG; (b) time from LMP until admission to hospital due to HG; (c) length of stay in hospital for HG; (d) re-admission to hospital for HG; (e) prompt recovery after therapeutic abortion or after delivery for HG and NVP patients; (f) the significance of HG in early pregnancy.
  10. 10. NVP in animals.

 

B. FACTORS IN A WOMAN’S PERSONAL HISTORY ………………………………RELATED TO NVP OR HG

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  1. Marital status.
  2. Wanted and unwanted pregnancy.
  3. Ethnic origin.
  4. Genetic factors.
  5. Pre-pregnancy motion sickness.
  6. Smoking cigarettes.
  7. Drinking alcohol.
  8. Age.
  9. Parity.
  10. Women’s initial weight.
  11. Previous nausea when taking an oral contraceptive.
  12. Diabetes.

 

C. OBSTETRIC CONDITIONS RELATED TO NVP OR HG

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  1. HG as a cause of maternal mortality.
  2. HG in relation to hydatidiform mole. NV related to choriocarcinoma.
  3. HG and previous unsuccessful pregnancy (abortion, stillbirth or neonatal death).
  4. Miscarriage in current pregnancy in relation to NVP.
  5. Reduced maternal weight gain.
  6. Pre-eclamptic toxaemia.
  7. Intra uterine growth retardation.
  8. Length of pregnancy  37 weeks in relation to NVP.
  9. Sex of baby.
  10. Birth weight of the baby.
  11. Twins.
  12. Placental weight, placental pathology.
  13. Fetal abnormalities. (a) Fetal abnormalities associated with HG; (b) specific fetal abnormalities associated with HG; (c) specific abnormalities less likely to occur with HG; (d) no increased fetal abnormality associated with HG; (e) no increased fetal abnormality associated with NVP; (f) freedom from NVP not related to fetal abnormality; (g) incidence of major congenital defects in the general population.
  14. Stillbirth and preinatal mortality.

 

D OTHER SIGNIFICANT FACTORS RELATING TO NVP & HG

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  1. Food cravings.
    37a. Food aversions.
  2. Caffeine and NVP.
  3. Factors that improve NVP.
  4. Factors that worsen NVP.
  5. Employment. Time lost from work.
  6. Adverse effects of severe NVP on the quality of pregnant women’s lives.
    42a. Does NVP require treatment? Early treatment is advisable.

 

E SUMMARY OF RESULTS & REFERENCES

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  1. Summary of Results.
  2. Factors significantly related to NVP or HG.
  3. Factors not related to NVP or HG.
  4. References.