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Ned Tijdschr Geneeskd 2022 Jun 15;166. Epub 2022 Jun 15.

Isala ziekenhuis, afd. Pathologie, Zwolle.

Background: About 200 pregnant women in the Netherlands are yearly diagnosed with cancer. Pregnant women with cancer are often diagnosed later than non-pregnant women because symptoms of cancer are common during pregnancy and may elude suspicion. We report a patient with gastric carcinoma masquerading as hyperemesis gravidarum. Read More

J Matern Fetal Neonatal Med 2022 Jun 21:1-9. Epub 2022 Jun 21.

Amsterdam University Medical Centers, University of Amsterdam, Department of Obstetrics and Gynecology, Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands.

Objective: To determine the prevalence of depression, anxiety, and posttraumatic stress disorder (PTSD) years after hyperemesis gravidarum (HG) and its association with HG severity.

Material And Methods: This prospective cohort study consisted of a follow-up of 215 women admitted for HG, who were eligible to participate in a randomized controlled trial and either declined or agreed to be randomized between 2013 and 2016 in 19 hospitals in the Netherlands. Participants completed the Hospital Anxiety and Depression Scale (HADS) six weeks postpartum and during follow-up and the PTSD checklist for DSM-5 (PCL-5) during follow-up. Read More

BMC Pregnancy Childbirth 2022 Jun 20;22(1):499. Epub 2022 Jun 20.

Department of Obstetrics and Gynecology, Balikesir University Medical Faculty, Balıkesir, Turkey.

Background: We aimed to investigate the levels of ADAMTS-1, which is secreted from the extracellular matrix during trophoblastic invasion in hyperemesis gravidarum (HEG).

Methods: In this cross-sectional study, we compared 45 HEG patients aged between 21 and 34 in terms of ADAMTS-1 levels with a control group consisting of 44 healthy pregnant women. The demographic characteristics and several laboratory parameters of the patients were recorded. Read More

BMC Pregnancy Childbirth 2022 Jun 2;22(1):464. Epub 2022 Jun 2.

Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway.

Background: Women suffering from severe nausea and vomiting during pregnancy, hyperemesis gravidarum, have poor quality of life and increased risk of potentially fatal maternal and fetal complications. There is increasing and reassuring knowledge about safety of antiemetics in pregnancy. In 2013, the European Medical Agency (EMA) issued a warning on metoclopramide limiting treatment to maximum five days. Read More

J Obstet Gynaecol 2022 May 29:1-6. Epub 2022 May 29.

Department of Obstetrics and Gynecology, Ufuk University Faculty of Medicine, Ankara, Turkey.

This is a prospective cohort study aimed to compare women treated due to hyperemesis gravidarum (HG) ( = 24) to women with normal pregnancy attending regular antenatal outpatient care ( = 22) in terms of fasting and post-prandial cholecystokinin (CCK) levels, and gallbladder (GB) functions. The Pregnancy-Unique Quantification of Emesis (PUQE) scores, fasting and postprandial CCK levels, and ultrasonographic GB parameters were recorded at admission before any treatment. The median PUQE score in the study group was 8. Read More

Prim Care Companion CNS Disord 2022 May 17;24(3). Epub 2022 May 17.

Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, Virginia.

AACE Clin Case Rep 2022 May-Jun;8(3):124-127. Epub 2022 Jan 3.

Division of Pediatric Endocrinology, College of Medicine, University of Florida, Gainesville, Florida.

Background: Transient thyrotoxicosis has been documented in the setting of hyperemesis gravidarum (HG) with elevated human chorionic gonadotropin (hCG) levels. Thyroid storm in pregnancy is rarer and typically associated with autoimmune hyperthyroidism. We described thyroid storm in a primigravid 18-year-old patient due to hCG level elevation secondary to HG, which resolved in the second trimester of pregnancy. Read More

BMJ Open 2022 05 19;12(5):e058364. Epub 2022 May 19.

Department of Obstetrics and Gynecology, University of Turku Faculty of Medicine, Turku, Finland.

Objectives: Pregnancy-Unique Quantification of Emesis (PUQE) questionnaire is mainly used in outpatient care to assess the severity of nausea and vomiting of pregnancy (NVP). Our aim was to evaluate the usability of the Finnish-translated PUQE in hospitalised women with hyperemesis gravidarum (HG).

Design: Prospective cohort study. Read More

Nutrients 2022 May 9;14(9). Epub 2022 May 9.

Department of Obstetrics and Gynecology, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.

Among the physiological changes occurring during pregnancy, the benefits of morning sickness, which is likely mediated by human chorionic gonadotropin (HCG) and induces serum ketone production, are unclear. We investigated the relationship between serum levels of ketone bodies and HCG in the first, second, and third trimesters and neonatal body shape (i.e. Read More

Cureus 2022 Apr 10;14(4):e24009. Epub 2022 Apr 10.

Department of Medicine, University of Illinois at Chicago, Chicago, USA.

Wernicke's encephalopathy (WE) is a rare neurologic disease caused by a deficiency in thiamine (B1). It is characterized by features of altered mental status, cerebellar dysfunction, and ophthalmoplegia. Most often, cases are attributed to long-term alcohol use; however, rarer causes have been described in the literature. Read More

J Sex Marital Ther 2022 May 9:1-12. Epub 2022 May 9.

Department of Midwifery, Faculty of Health Sciences, Aydın Adnan Menderes University, Aydın, Turkey.

The objective of this study is to examine the relationship between nausea and vomiting during pregnancy (NVP) and attachment styles in close relationships, marital adjustment, and ways of coping with stress. This study was performed in 2019 as an analytic case-control design. The study group consists of 60 pregnant women hospitalized with a nausea-vomiting/hyperemesis gravidarum diagnosis. Read More

Geburtshilfe Frauenheilkd 2022 May 6;82(5):517-527. Epub 2022 May 6.

Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

There is limited research on effective treatment of Hyperemesis Gravidarum (HG), the most extreme version of nausea and vomiting during pregnancy (NVP). This paper examines current patterns of use and self-reported effectiveness of cannabis/cannabis-based products (CBP) to treat HG. The study employed a 21-question survey to gather information on demographics, antiemetic prescription use, and experience with cannabis/CBPs among individuals who experienced extreme nausea and vomiting or HG during their pregnancy. Read More

Cureus 2022 Apr 4;14(4):e23800. Epub 2022 Apr 4.

Internal Medicine, HCA Florida North Florida Hospital, Gainesville, USA.

Various complications of hyperemesis gravidarum and pneumomediastinum have been documented in the literature. Commonly, these cases resolve spontaneously or with the use of antiemetics and supportive care. In rare instances, these symptoms persist into the second trimester and are associated with an increased risk of complications. Read More

Br J Clin Pharmacol 2022 Apr 28. Epub 2022 Apr 28.

PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, and PharmaTox Strategic Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway.

Aims: The objective of this study was to describe ondansetron drug utilization patterns during pregnancy to treat nausea and vomiting in pregnancy (NVP). Moreover, we aimed to describe the maternal factors associated with NVP and antiemetic use.

Methods: The data consist of pregnancies with a live birth(s) within an IMRD-UK registered GP practice. Read More

PLoS One 2022 26;17(4):e0266054. Epub 2022 Apr 26.

School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.

Background: Hyperemesis gravidarum is severe nausea and excessive vomiting, starting between 4 and 6 gestational weeks, peak at between 8 and 12 weeks and usually improve and subside by 20 weeks of pregnancy. Identifying the determinants of hyperemesis gravidarum has a particular importance for early detection and intervention to reduce the health, psychosocial and economic impact. In Ethiopia there is low information on determinants of hyperemesis gravidarum. Read More

Rev Bras Ginecol Obstet 2022 May 11;44(5):458-466. Epub 2022 Apr 11.

Sakarya University, School of Medicine, Sakarya Training and Research Hospital, Department of Obstetrics and Gynecology, Sakarya, Turkey.

Objective:  Hyperemesis gravidarum (HG) is a pregnancy complication that can progress with persistent nausea and vomiting. The aim of the present study is to evaluate the relationship between hematological parameters and HG.

Method:  A total of 532 pregnant women with HG who were admitted to the Department of Obstetrics and Gynecology between March 2019 and February 2021, and 534 healthy pregnant women with characteristics similar to those of the case group were included in the study. Read More

Am J Obstet Gynecol 2022 Mar 30. Epub 2022 Mar 30.

Department of Obstetrics and Gynecology, Amsterdam Reproduction & Development, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

Objective: Hyperemesis gravidarum is characterized by severe nausea and vomiting in pregnancy, frequently resulting in severe maternal nutritional deficiency. Maternal undernutrition is associated with adverse offspring health outcomes. Whether hyperemesis gravidarum permanently affects offspring health remains unclear. Read More

BMJ Open 2022 03 31;12(3):e051295. Epub 2022 Mar 31.

Department of Psychology "Renzo Canestrari", University of Bologna, Bologna, Italy.

Introduction: Hyperemesis gravidarum (HG) is a condition characterised by dehydration, electrolyte imbalance, lack of nutrition and at least 5% loss in body weight, occurring in the first half of pregnancy. The aim of this trial is to examine the efficacy of group biofeedback treatment on patients with HG with psychosomatic symptoms, which will be evaluated through the revised version of Diagnostic Criteria for Psychosomatic Research (DCPR-R).

Methods And Analysis: In this single-blinded randomised controlled clinical trial, 68 patients with HG diagnosed with at least one psychosomatic syndrome according to DCPR-R and aged 18-40 years, will be recruited in a Chinese Maternal and Child Health Hospital. Read More

J Pak Med Assoc 2022 Mar;72(3):550-553

Department of Internal Medicine, Shifa International Hospital, Islamabad, Pakistan.

Wernicke's encephalopathy (WE) is an acute neurological condition characterized by a triad of ophthalmoplegia, ataxia and altered mental status. The underlying cause is thiamine deficiency, which may be due to multiple aetiologies. Thiamine is essential for carbohydrate and amino acid metabolism. Read More

Eur Rev Med Pharmacol Sci 2022 Mar;26(5):1601-1606

Hitit University, School of Medicine Department of Obstetrics and Gynecology, Çorum, Turkey.

Objective: This study aims to determine the voice and gastrointestinal system changes of patients with hyperemesis gravidarum in the first trimester and to compare them with healthy pregnant women.

Patients And Methods: This study was conducted prospectively. Two groups were defined as hyperemesis and healthy pregnant women. Read More

J Obstet Gynaecol 2022 Mar 17:1-7. Epub 2022 Mar 17.

Department of General Surgery, Gaziosmanpasa University School of Medicine, Tokat, Turkey.

Pregnancy is one of the risk factors for biliary sludge (BS) formation. In this cross-sectional study, a total of 959 pregnant women were included. Serum aspartate aminotransferase, alanine aminotransferase, sodium, potassium, triglycerides, cholesterol levels and the presence of ketones in urine were determined. Read More

BMC Pregnancy Childbirth 2022 Mar 12;22(1):199. Epub 2022 Mar 12.

Japan Environment and Children's Study, UOEH Subunit Center, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.

Background: Women with nausea and vomiting of pregnancy (NVP) have higher birth weight infants, while those with hyperemesis gravidarum, a severe manifestation of NVP, have lower birth weight infants. We aimed to investigate the associations between maternal weight loss (a consequence of hyperemesis gravidarum), NVP, and infant birth weight.

Methods: This study was a secondary analysis of a nationwide birth cohort in Japan. Read More

Gastroenterology 2022 Jul 8;163(1):97-117.e1. Epub 2022 Mar 8.

Department of Women and Children's Health, King's College London, London, UK.

The liver disorders unique to pregnancy include hyperemesis gravidarum, intrahepatic cholestasis of pregnancy, acute fatty liver of pregnancy, and preeclampsia-associated hepatic impairment, specifically hemolysis, elevated liver enzymes, and low platelet count syndrome (HELLP). Their importance lies in the significant maternal and fetal/neonatal morbidity and mortality. Expeditious diagnosis and clinical evaluation is critical to ensure timely, appropriate care and minimize risks to the pregnant woman and her fetus/baby. Read More

J Obstet Gynaecol 2022 Mar 9:1-5. Epub 2022 Mar 9.

Obstetrics and Gynecology Department, Veris delli Ponti Hospital, Scorrano, Lecce, Italy.

We investigated the serum anti-Mullerian hormone (AMH), oestrogen and progesterone levels in spontaneously conceiving pregnant women, diagnosed for hyperemesis gravidarum (HG), in the first trimester. Pregnant women admitted at Hospital between 5 and 12 gestational weeks and treated for HG were compared, in this prospective case-control study, to a control group. The serum AMH, oestradiol, and progesterone values of both groups were evaluated and compared, and potential correlations were calculated. Read More

J Matern Fetal Neonatal Med 2022 Mar 3:1-4. Epub 2022 Mar 3.

PGY 1 Family Medicine, University of Calgary, Calgary, Alberta, Canada.

Hyperemesis gravidarum is a rare but potentially serious complication of pregnancy. Some women with severe symptoms and possibly psychiatric comorbidities remain symptomatic despite the use of currently available treatments. Due to its favorable safety profile, antiemetic efficacy in other conditions, and 5-HT3 antagonism, olanzapine may be a potentially useful addition to the armamentarium for management of hyperemesis gravidarum resistant to standard- of-care treatment. Read More

Arch Gynecol Obstet 2022 Feb 28. Epub 2022 Feb 28.

Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland.

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. Read More

BJOG 2022 Feb 25. Epub 2022 Feb 25.

Department of Maternal Fetal Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.

Br J Nutr 2022 Feb 24:1-30. Epub 2022 Feb 24.

Amsterdam UMC, University of Amsterdam, Department of Obstetrics and Gynaecology, Amsterdam Reproduction & Development Research Institute, Meibergdreef 9, Amsterdam, the Netherlands.

The present study aimed to investigate the association between hyperemesis gravidarum (HG) severity and the effect of early enteral tube feeding on cardiometabolic markers in offspring cord blood. We included women admitted for HG, who participated in the MOTHER randomized controlled trial (RCT) and observational cohort. The MOTHER RCT showed that early enteral tube feeding in addition to standard care did not affect symptoms or birth outcomes. Read More

Pan Afr Med J 2021 20;40:240. Epub 2021 Dec 20.

Department of Gynecology and Obstetrics, University of Medicine of Sfax, Hedi Chaker Hospital, 3029, Sfax, Tunisia.

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. Read More

Arab J Gastroenterol 2022 May 10;23(2):89-94. Epub 2022 Feb 10.

Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt. Electronic address:

Background And Study Aims: Pregnancy in association with cirrhosis is a rather uncommon and highly risky situation for both mother and child. We aim to study all factors and the utility of liver stiffness (LS) measurement by Acoustic Radiation Force Impulse elastography (ARFI) to predict hepatic decompensation in pregnant cirrhotic patients.

Patients And Methods: We prospectively recruited 224 pregnant women at the multidisciplinary clinic of liver disease with pregnancy, Cairo University. Read More