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Hiperemesis en el embarazo: complicaciones y tratamiento
Angeliki Gerede1, Sofoklis Stavros2, Efthalia Moustakli3
1Department of Obstetrics and Gynecology, Democritus University of Thrace, 69100 Alexandroupolis Campus, Greece.
Medical sciences (Basel, Switzerland)
|August 22, 2025
Resumen
La hiperemesis gravidarum (HG), una forma grave de náuseas y vómitos en el embarazo, conduce a complicaciones maternas significativas. Los tratamientos actuales incluyen doxilamina-piridoxina y otras terapias, pero la investigación está en curso para mejorar el manejo.
Área de la Ciencia:
- Obstetricia y ginecología
- Medicina materna y fetal
- Farmacología
Sus antecedentes:
- La hiperemesis gravídica (HG) es la forma más grave de náuseas y vómitos en el embarazo (NVP), que afecta al 0,3- 3% de los embarazos.
- HG es una de las principales causas de hospitalización temprana del embarazo, asociada con una morbilidad materna significativa y posibles resultados adversos en el feto.
- La fisiopatología de HG no se entiende completamente, y el manejo óptimo sigue siendo objeto de debate.
Objetivo del estudio:
- Revisar las pruebas actuales sobre las complicaciones asociadas con el HG.
- Para sintetizar la información sobre los diferentes enfoques de tratamiento para la GH.
- Resaltar la necesidad de estrategias de gestión integrales e individualizadas.
Principales métodos:
- Una reseña narrativa de la literatura existente.
- Búsqueda de literatura realizada en PubMed, Scopus y Medline hasta octubre de 2024.
- La inclusión de estudios observacionales, estudios de cohorte, estudios descriptivos y informes de casos.
Principales resultados:
- Las complicaciones de HG incluyen deshidratación, desequilibrios electrolíticos, encefalopatía de Wernicke, arritmias cardíacas, tromboembolismo, restricción del crecimiento fetal y parto prematuro.
- Los tratamientos farmacológicos como la doxilamina-piridoxina (aprobada por la FDA), el ondansetrón, la metoclopramida y los corticosteroides muestran una eficacia y seguridad variadas.
- Las intervenciones no farmacológicas como la acupresión, los cambios en la dieta, la psicoterapia y la hipnosis tienen evidencia de apoyo limitada.
Conclusiones:
- HG requiere un plan de gestión integral e individualizado.
- La doxilamina-piridoxina es una terapia primaria, con otros agentes y medidas de apoyo potencialmente beneficiosas.
- La investigación adicional es crucial para comprender los mecanismos de GH, mejorar la eficacia del tratamiento y desarrollar pautas basadas en la evidencia que integren la atención médica y psicosocial.
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