Maltepe Caroline, Koren Gideon
The Motherisk Program, Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, Canada M5G 1X8.
Obstet Gynecol Int. 2013;2013:809787. doi: 10.1155/2013/809787. Epub 2013 Feb 17.
Objectives. To determine whether the initiation of treatment (preemptive treatment) before the symptoms of nausea and vomiting of pregnancy (NVP) versus when the symptoms begin can improve the outcome in patients at a high risk for recurrence of severe NVP. Study Design. Prospective, randomized controlled trial. Results. Preemptive therapy conferred a significant reduction in HG as compared to the previous pregnancy (P = 0.047). In the preemptive arm, there were 2.5-fold fewer cases of moderate-severe cases of NVP than those in the control group (15.4% versus 39.13%) in the first 3 weeks of NVP (P = 0.05). In the preemptive group, significantly more women had their NVP resolved before giving birth (78.2% versus 50%) (P < 0.002). Conclusions. Preemptive treatment with antiemetics is superior to the treatment that starts only when the symptoms have already occurred in decreasing the risk of severe forms of NVP.
目的。确定在妊娠恶心和呕吐(NVP)症状出现之前开始治疗(预防性治疗)与症状开始时进行治疗相比,是否能改善严重NVP复发高危患者的结局。研究设计。前瞻性随机对照试验。结果。与前次妊娠相比,预防性治疗使重度恶心和呕吐(HG)显著减少(P = 0.047)。在预防性治疗组中,NVP前3周中重度NVP病例比对照组少2.5倍(15.4%对39.13%)(P = 0.05)。在预防性治疗组中,明显更多的女性在分娩前NVP症状得到缓解(78.2%对50%)(P < 0.002)。结论。在降低严重形式NVP的风险方面,使用止吐药的预防性治疗优于仅在症状已经出现时才开始的治疗。