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Nausea and vomiting of pregnancy - What's new?

  • Martha Bustos
    Affiliations
    School of Pharmacy, Department of Pharmaceutical Sciences, University of Pittsburgh, 716 Salk Hall, 3501 Terrace St, Pittsburgh, PA 15261, United States
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  • Raman Venkataramanan
    Affiliations
    School of Pharmacy, Department of Pharmaceutical Sciences, University of Pittsburgh, 716 Salk Hall, 3501 Terrace St, Pittsburgh, PA 15261, United States

    Department of Pathology, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15261, United States
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  • Steve Caritis
    Correspondence
    Corresponding author at: Magee-Womens Hospital of UPMC, 300 Halket St., Suite 0610, Pittsburgh, PA 15213., United States.
    Affiliations
    Department of Obstetrics, Gynecology and Reproductive Sciences Magee Womens Hospital, 300 Halket St., Pittsburgh, PA 15213-3180, United States

    School of Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, 300 Halket Street, Pittsburgh, PA 15213, United States
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      Abstract

      Nausea and vomiting of pregnancy (NVP) is one of the most common disorders of pregnancy. The symptoms occur predominantly during the first trimester, although in a subgroup of patients they can continue throughout the entire pregnancy and can affect the woman's quality of life. A small percentage of women develop a severe form of NVP called hyperemesis gravidarum (HG) that if left untreated may lead to significant maternal morbidity and adverse birth outcomes. Overall, the morbidity in pregnant women with NVP is significant, although it tends to be underestimated. The pathogenesis of NVP remains unclear, but there is consensus that the disorder is multifactorial and that various genetic, endocrine and infectious factors may be involved. The treatment of NVP can be challenging as the optimal targets for therapy are not known. Currently, the therapy used depends on the severity of the disorder and it is focused on improving the symptoms while minimizing risks to mother and fetus. Therapies range from dietary changes, pharmacologic treatment or hospitalization with intravenous fluid replacement and nutrition therapy. The aims of this review are 1) to provide an overview of NVP, 2) to present possible links between the most important factors associated with the pathogenesis of NVP and 3) to discuss the effectiveness and safety of the pharmacologic and non-pharmacologic options available to treat this disorder.

      Abbreviations:

      NVP (Nausea and vomiting of pregnancy), HG (Hyperemesis gravidarum), PUQE (Pregnancy-Unique Quantification of Emesis scoring), TNF-a (Tumor necrosis factor alpha), IL-1 (Interleukin 1), IL-6 (Interleukin 6), hCG (Human chorionic gonadotrophin), H. pylori (Helicobacter pylori)

      Keywords

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