Abstract
Up to 90% of pregnant women experience nausea and vomiting. When prolonged or severe, this is known as hyperemesis gravidarum (HG), which can, in individual cases, be life threatening. In this article the aetiology, diagnosis and treatment strategies will be presented based on a selective literature review. Treatment strategies range from outpatient dietary advice and antiemetic drugs to hospitalization and intravenous (IV) fluid replacement in persistent or severe cases. Alternative methods, such as acupuncture, are not yet evidence based but sometimes have a therapeutic effect.In most cases, the condition is self limiting and subsides by around 20 weeks gestation. More severe forms require medical intervention once other organic causes of nausea and vomiting have been excluded. In addition, a psychosomatic approach is often helpful.In view of its potential complexity, general practitioners and obstetricians should be well informed about HG and therapy should be multimodal.
Highlights
About 50% - 90% of all pregnancies are accompanied by nausea and vomiting [1]
In up to 20% of cases, nausea and vomiting may continue until delivery [1]. This condition is known as nausea and vomiting during pregnancy (NVP) or emesis gravidarum and is of no pathological significance as long as the affected women do not feel unwell or restricted in their daily life [2]
There are, different grades in the scope of NVP, which range from occasional morning-sickness to excessive vomiting that persists throughout the day
Summary
About 50% - 90% of all pregnancies are accompanied by nausea and vomiting [1]. According to a study of more than 360 pregnant women, only 2% experienced only nausea in the morning whereas, in 80%, complaints persisted throughout the day. An investigation of 147 patients evaluated the impact of NVP on family, social and occupational functioning as well as quality of life It found that 82.8% of patients were limited in their usual daily activities, by the presence of constant nausea and frequent vomiting, and by the psychological burden of not feeling well for several weeks or months [91]. Another stressful aspect of the disorder is the change of the patient's role within her social or occupational environment: Many women feel helpless and incapable and misunderstood by their relatives. Adequate assessment, observation, and treatment of a possible psychosomatic disorder should be considered
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