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J Obstet Gynaecol Res 2021 Jun 9. Epub 2021 Jun 9.

Department of Gynecology and Obstetrics, Kütahya Health Sciences University, Kutahya, Turkey.

Objective: Hyperemesis gravidarum is an illness that starts in early pregnancy and manifests itself with oral intake problems, electrolyte imbalance, ketonuria, and weight loss. Inflammation is closely associated with the hyperemesis gravidarum, and inflammatory indicators have been studied to understand its pathophysiology. This study investigates the relationship of ketonuria levels with inflammatory markers platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and neutrophil-to-lymphocyte ratio (NLR) for hyperemesis gravidarum patients. Read More

Turk J Obstet Gynecol 2021 06;18(2):115-123

University of Health Sciences Turkey, Ankara Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey

Objective: To compare the psychological resilience and anxiety levels of patients diagnosed with hyperemesis gravidarum (HG) and healthy pregnant women.

Materials And Methods: A sociodemographic data form and the Resilience scale for Adults (RSA) and the State-Trait Anxiety Inventory (STAI) were administered. The sociodemographic data form was completed by the physician, and the RSA and STAI were completed by the participant. Read More

Nutr Neurosci 2021 May 27:1-6. Epub 2021 May 27.

Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Objectives: Hyperemesis gravidarum is known to induce nutritional, water and electrolyte deficiencies which can be fatal if not treated urgently. Thiamine deficiency may lead to a constellation of neurological symptoms that include Wernicke encephalopathy. Moreover, Wernicke encephalopathy is typically manifested as ocular paresis, ataxia and confusion. Read More

Acta Obstet Gynecol Scand 2021 May 25. Epub 2021 May 25.

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

Introduction: Hyperemesis gravidarum (HG) complicates 1% of pregnancies and has a major impact on maternal quality of life and wellbeing. We know very little about HG's long-term impact after an affected pregnancy, including recurrence rates in future pregnancies, which is essential information for women considering subsequent pregnancies. In this study, we aimed to prospectively measure the recurrence rate of HG and the number of postponed and terminated subsequent pregnancies due to HG. Read More

J Family Med Prim Care 2021 Jan 30;10(1):567-571. Epub 2021 Jan 30.

Department of Neuromedicine, Bangur Institute of Neurosciences, Institute of Postgraduate Medical Education & Research and SSKM Hospital, Kolkata, West Bengal, India.

Wernicke's encephalopathy (WE) is an acute neurological condition characterized by the triad of ophthalmoparesis with nystagmus, ataxia, and global confusion. WE is a life-threatening illness caused by thiamine deficiency, primarily affecting the peripheral and central nervous systems. Thiamine deficiency is predominantly associated with chronic alcoholism, but various other causes have also been reported, including severe malnutrition, prolonged parenteral nutrition, malignancies, immunodeficiency syndromes, liver disease, hyperthyroidism and severe anorexia nervosa, and hyperemesis gravidarum. Read More

J Matern Fetal Neonatal Med 2021 Jul 5;34(13):2117-2123. Epub 2019 Sep 5.

Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, Canada.

Purpose: Celiac disease (CD) is a permanent immune reaction to gluten that is likely related to genetic factors. Some studies have linked CD to adverse maternal and/or neonatal outcomes but the data has been contradictory. The purpose of this study was to evaluate the effect of CD on pregnancy outcomes. Read More

J Neurol Sci 2021 Jul 7;426:117482. Epub 2021 May 7.

Experimental Psychology, Helmholtz Institute, Utrecht University, the Netherlands; Slingedael Korsakoff Center, Lelie Care Group, Rotterdam, the Netherlands.

Background: Wernicke-Korsakoff syndrome (WKS) is a neurological disorder typically found in alcohol use disorder. The fact that it also occurs in nonalcoholic patients is less well known and often ignored. For the first time, this review offers a systematic investigation of the frequency and associated features of nonalcoholic WKS in the published literature. Read More

BMJ Open 2021 05 13;11(5):e046528. Epub 2021 May 13.

Obstetrics and Gynaecology, University of Malaya, Kuala Lumpur, Malaysia.

Objective: To evaluate four foods in women with hyperemesis gravidarum (HG) on their agreeability and tolerability.

Design: Prospective, randomised, within-subject cross-over trial.

Setting: Single-centre, tertiary, university hospital in Malaysia. Read More

Aust N Z J Obstet Gynaecol 2021 May 13. Epub 2021 May 13.

SA Pharmacy, Flinders Medical Centre, SA Health, Adelaide, South Australia, Australia.

We conducted an online survey of 249 Australian women who currently or previously experienced severe nausea and vomiting of pregnancy (NVP) or hyperemesis gravidarum (HG) and examined their experiences in being denied medications during pregnancy. One in four women reported being denied medications for NVP/HG, which most commonly involved doxylamine and encounters with community pharmacists. Women's experiences reflected that lack of awareness of guidelines and unfavourable risk-benefit assessments appeared to be key barriers to facilitating medication access. Read More

Exp Ther Med 2021 Jun 16;21(6):642. Epub 2021 Apr 16.

Department of Neurology, 'Iuliu Hatieganu' University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca 400012, Romania.

Hyperemesis gravidarum (HG) refers to severe nausea and emesis noted during pregnancy. However, no consensus exists on the specific diagnostic criteria that can be used for this condition. The aim of the present systematic review was to summarize the available evidence regarding the severe complications observed during HG with a heightened risk of fatality. Read More

Taiwan J Obstet Gynecol 2021 May;60(3):422-432

Department of Midwifery, University of West Attica, Athens, Greece.

Hyperemesis gravidarum (HG) is associated with adverse somatic and psychological effects. The impact of HG on neonatal outcomes is debatable given that disagreeing research results have appeared. The objective of this study was to systematically review, according to the PRISMA guidelines, and synthesize the available evidence from observational studies on the relationship between HG and neonatal outcomes. Read More

BMC Pregnancy Childbirth 2021 May 9;21(1):366. Epub 2021 May 9.

Department of Obstetrics Gynecology, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Shandong, 250012, Jinan, China.

Background: Hyperemesis gravidarum (HG) is a common complication during pregnancy, however, HG associated simultaneous onset of blood cell destruction due to electrolyte abnormalities is rare. In this case, a woman with refeeding syndrome (RFS) secondary to electrolyte abnormalities caused by severe HG was diagnosed and managed in our hospital.

Case Presentation: A 29-year old woman was sent to the local hospitals because of severe HG with appetite loss, weight reduction, general fatigue, and she was identified to have severe electrolyte abnormalities. Read More

J Obstet Gynaecol 2021 May 4:1-8. Epub 2021 May 4.

School of Health Sciences, Tampere Research and Innovation Center and University of Tampere, Tampere University Hospital, Tampere, Finland.

Nausea or vomiting in pregnancy (NVP) are among the commonest symptoms experienced in early pregnancy. We wanted to evaluate the association of dietary fibre intake, lifestyle characteristics and bowel function with NVP. One hundred and eighty-eight participants completed a self-administered questionnaire concerning bowel function, dietary fibre intake and lifestyle characteristics. Read More

Ugeskr Laeger 2021 04;183(15)

This is a case report of a 19-year-old woman with cannabinoid hyperemesis syndrome (CHS), which is characterised by cyclic vomiting and nausea, relieved by hot showers and caused by chronic cannabis usage. Many diagnoses must be ruled out, but the suspicion of cannabis usage must be present. Early suspicion of CHS can prevent overtreatment and unnecessary investigations. Read More

Ann Emerg Med 2021 05;77(5):555

Department of Emergency Medicine, McGill University, Montreal, Quebec, Canada, Centre Antipoison du Québec, Québec, Quebec, Canada.

Ann Epidemiol 2021 Mar 30;59:10-15. Epub 2021 Mar 30.

Institut national de santé publique du Québec, Montreal, QC, Canada; University of Montreal Hospital Research Centre, Montreal, QC, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, QC, Canada. Electronic address:

Purpose: We assessed whether the protective association between hyperemesis gravidarum and birth defects could be due to selection bias from exclusion of pregnancy terminations.

Methods: We designed a cohort study of 2,115,581 live births in Canada, 1990-2016. The main exposure measure was hyperemesis gravidarum. Read More

Neurohospitalist 2021 Apr 4;11(2):141-147. Epub 2020 Sep 4.

Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Philippines.

Background: Wernicke-Korsakoff syndrome (WKS) is a triad of ophthalmoplegia, ataxia and memory deficits due to thiamine insufficiency resulting from under- or untreated Wernicke's encephalopathy (WE), which may be associated with hyperemesis gravidarum (HEG).

Case Presentation: We present a case of a 36-year-old Filipino woman in her first trimester with HEG, along with the WKS triad and abnormal hyperintense signals in the bilateral thalami and midbrain, left occipital lobe, periaqueductal gray matter and pontine periventricular areas. Neurologic deficits partially improved but persisted despite intravenous thiamine administration. Read More

BMJ 2021 03 31;372:n645. Epub 2021 Mar 31.

Guy's and St Thomas' Hospital NHS Trust, St Thomas' Hospital, London, UK.

BMC Pregnancy Childbirth 2021 Mar 26;21(1):254. Epub 2021 Mar 26.

Health Economics Unit, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.

Background: Smoking during pregnancy (SDP) and the postpartum period has serious health outcomes for the mother and infant. Although some systematic reviews have shown the impact of maternal SDP on particular conditions, a systematic review examining the overall health outcomes has not been published. Hence, this paper aimed to conduct an umbrella review on this issue. Read More

BMJ Case Rep 2021 Mar 24;14(3). Epub 2021 Mar 24.

Internal Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, Florida, USA.

Cureus 2021 Feb 17;13(2):e13405. Epub 2021 Feb 17.

Medicine, C U Shah Medical College, Surendranagar, IND.

Introduction  During pregnancy, liver dysfunction is more frequent than expected and may require specialized care. For the early diagnosis, it is important to determine if changes in liver physiology may develop into liver disease. Liver disease during pregnancy may require intervention from a hepatologist for adequate monitoring of mother-fetus health outcomes. Read More

J Obstet Gynaecol Res 2021 Jun 22;47(6):2005-2013. Epub 2021 Mar 22.

Nursing Department, Ankara Yıldırım Beyazıt University Faculty of Health Sciences, Ankara, Turkey.

Aim: This study investigated the association between quality of life and complementary and alternative medicine (CAM) use in pregnant women with hyperemesis gravidarum in Turkey.

Methods: This cross-sectional descriptive study was conducted between October 2017 and July 2018 in Turkey. The sample consisted of 240 pregnant women with hyperemesis gravidarum. Read More

BMJ Case Rep 2021 Mar 16;14(3). Epub 2021 Mar 16.

Medicine, Kasturba Medical College Mangalore, Mangalore, India.

We report a case of a 26-year-old pregnant woman, who presented with subacute limb weakness. This was initially suspected to be Guillain-Barre syndrome but subsequently found to be the motor neuropathy of dry beriberi (vitamin B1, thiamine deficiency) along with associated Wernicke's encephalopathy (WE). The underlying cause was revealed as hyperemesis gravidarum (HG). Read More

Heliyon 2021 Feb 22;7(2):e06323. Epub 2021 Feb 22.

Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

Background: Adverse pregnancy outcomes are the most significant public health problem which leads to serious short and long-term health consequences to the mother and the newborn baby. Adverse pregnancy outcomes, especially prematurity and low birth weights are the major cause of neonatal morbidity and mortality in Ethiopia, particularly in the study area. Therefore, this study was aimed to determine predictors of adverse pregnancy outcome among mothers who gave birth at Hospitals in South Gondar zone, North-central Ethiopia. Read More

Clin Epidemiol 2021 26;13:161-174. Epub 2021 Feb 26.

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

Objective: To determine antiemetic prescription fill patterns during pregnancy in Norway, with special focus on the use of ondansetron and recurrent use in subsequent pregnancies.

Methods: We conducted a population-based registry study based on data from the Medical Birth Registry of Norway linked to the Norwegian Prescription Database for 762,437 pregnancies >12 gestational weeks ending in live or non-live births between 2005 and 2017. Prescription fills of medications used for nausea and vomiting of pregnancy were summarized in treatment pathways to determine drug utilization patterns. Read More

Acta Obstet Gynecol Scand 2021 Feb 19. Epub 2021 Feb 19.

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

Introduction: Little is known about the pathophysiology of hyperemesis gravidarum (HG). Proposed underlying causes are multifactorial and thyroid function is hypothesized to be causally involved. In this study, we aimed to assess the utility of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) as a marker and predictor for the severity and clinical course of HG. Read More

Arch Gynecol Obstet 2021 Feb 16. Epub 2021 Feb 16.

Adana Ortadoğu Hospital, ENT Clinics, Adana, Turkey.

Purpose: This study aimed to compare the first-trimester pregnancy serum total oxidative status (TOS), total antioxidant status (TAS), and serum estradiol levels as well as the olfactory functions assessed using the brief smell identification test (BSIT) of women with healthy pregnancies and those with hyperemesis gravidarum (HG).

Methods: In this prospective study, 60 pregnant women in the first trimester of their pregnancies were divided into two groups: 30 pregnant women with HG (study group) and 30 healthy pregnant women (control group). The following parameters were compared in the HG group and the healthy controls: TOS, TAS, serum levels of estradiol (E2), and olfactory function, which was measured using BSIT. Read More

Tidsskr Nor Laegeforen 2021 02 1;141(2). Epub 2021 Feb 1.

Background: Immigrant women are a vulnerable group within Norwegian prenatal care and have an increased risk of adverse pregnancy outcomes. The purpose of this exploratory literature review was to compile an overview of the available knowledge on the prenatal health of immigrant women in Norway.

Evidence Base: The literature review covers 44 peer-reviewed articles on the prenatal health of immigrant women in Norway. Read More

Int J Dermatol 2021 06 1;60(6):e244-e246. Epub 2021 Feb 1.

Department of Dermatology, Lozano Blesa University Clinical Hospital, Zaragoza, Spain.