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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Article info
Publication history
Published online: May 13, 2016
Accepted:
May 11,
2016
Received in revised form:
May 10,
2016
Received:
April 2,
2016
Identification
Copyright
© 2016 Elsevier B.V. All rights reserved.
