Nausea and vomiting of pregnancy

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Gastroenterology

Background:

• Nausea and vomiting of pregnancy (NVP) is a common condition, affecting up to 90% of pregnant women.
• NVP exists on a spectrum from mild, self-limiting symptoms to severe hyperemesis gravidarum (HG) with metabolic disturbances and weight loss.
• The exact cause of NVP and HG is unknown, with multifactorial theories involving biological and psychological factors.

Purpose of the Study:

• To review the current understanding of NVP and HG.
• To discuss diagnostic considerations and management strategies.
• To highlight the importance of conservative and pharmacologic interventions, as well as alternative therapies.

Main Methods:

• Literature review of NVP and HG.
• Synthesis of information on pathogenesis, diagnosis, and management.
• Discussion of prognosis and potential risks to mother and fetus.

Main Results:

• NVP is common, with HG representing a severe form.
• Diagnosis is typically clinical, but organic causes must be excluded in severe/prolonged cases.
• Prognosis for typical NVP is excellent; HG's fetal risk is debated.

Conclusions:

• Initial management involves conservative measures like dietary changes and reassurance.
• Pharmacologic therapy is reserved for persistent symptoms after informed consent.
• Alternative therapies and nutritional support are crucial in refractory cases; therapeutic abortion is a last resort.