Clark Shannon M, Costantine Maged M, Hankins Gary D V
Division of MFM, Department of Obstetrics and Gynecology, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA.
Obstet Gynecol Int. 2012;2012:252676. doi: 10.1155/2012/252676. Epub 2011 Nov 24.
NVP occurs in 50-90% of pregnancies, making it a common medical condition in pregnancy. Women present differently with any combination of signs and symptoms. It is appropriate to take the pregnancy-related versus nonpregnancy-related approach when determining the cause of nausea and vomiting but other causes should be considered. The most common etiologies for NVP include the hormonal changes associated with pregnancy, the physiologic changes in the gastrointestinal tract, and a genetic predisposition. Up to 10% of women will require pharmacotherapy to treat the symptoms of NVP despite conservative measures. ACOG currently recommends that a combination of oral pyridoxine hydrochloride and doxylamine succinate be used as first-line treatment for NVP if pyridoxine monotherapy does not relieve symptoms. A review of NVP and early pharmacotherapeutic management is presented due to the fact that NVP is largely undertreated, and investigations into the safe and effective pharmacotherapies available to treat NVP are lacking.
妊娠剧吐(NVP)发生于50%至90%的孕期女性中,使其成为孕期常见的病症。女性出现的体征和症状组合各不相同。在确定恶心和呕吐的病因时,采用与妊娠相关和与非妊娠相关的方法是合适的,但也应考虑其他病因。妊娠剧吐最常见的病因包括与妊娠相关的激素变化、胃肠道的生理变化以及遗传易感性。尽管采取了保守措施,仍有高达10%的女性需要药物治疗来缓解妊娠剧吐的症状。美国妇产科医师学会(ACOG)目前建议,如果单用盐酸吡哆醇不能缓解症状,可将口服盐酸吡哆醇和琥珀酸多西拉敏联合用作妊娠剧吐的一线治疗。鉴于妊娠剧吐在很大程度上未得到充分治疗,且缺乏对可用于治疗妊娠剧吐的安全有效药物疗法的研究,本文对妊娠剧吐及早期药物治疗管理进行综述。