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[孕期恶心与呕吐的处理方法]

[THE APPROACH TO NAUSEA AND VOMITING IN PREGNANCY].

作者信息

Shtomo Meital, Cohen Rana, Berkovitch Mati, Koren Gideon

出版信息

Harefuah. 2015 Nov;154(11):720-4, 741.

Abstract

Nausea and vomiting of pregnancy (NVP) is the most prevalent medical condition during gestation. Approximately 85% of pregnant women suffer from some degree of this condition, while hyperemesis gravidarum (HG), the most severe form, affects up to 2% of women. Although being the leading cause for hospitalization during pregnancy, NVP has received little attention from the medical community. NVP negatively affects women's quality of life, household activity and work productivity. In Canada, the financial cost of NVP, ranges from $132 to $653 per woman/week. In extreme cases, severe NVP results in therapeutic abortions. On the other hand, NVP has been shown to have a protective effect against spontaneous abortions and congenital malformations. Lately, there has been an interest in the hypothesis that NVP is a mechanism protecting the fetus from phytochemicals. Early treatment can prevent future complications and deterioration of the symptoms. Various studies have demonstrated the effectiveness and safety of antiemetic therapy in pregnancy. However, fear of teratogenicity and lack of clinical guidelines lead to trial and error NVP management. We present an updated algorithm for the management of NVP.

摘要

妊娠恶心和呕吐(NVP)是孕期最常见的病症。约85%的孕妇会出现某种程度的该病症,而最严重的形式——妊娠剧吐(HG)影响着高达2%的女性。尽管NVP是孕期住院的主要原因,但医学界对其关注甚少。NVP会对女性的生活质量、家庭活动和工作效率产生负面影响。在加拿大,NVP的经济成本为每位女性每周132美元至653美元。在极端情况下,严重的NVP会导致治疗性流产。另一方面,已证明NVP对自然流产和先天性畸形具有保护作用。最近,人们对NVP是一种保护胎儿免受植物化学物质影响的机制这一假说产生了兴趣。早期治疗可预防未来并发症和症状恶化。多项研究已证明妊娠期间使用止吐疗法的有效性和安全性。然而,对致畸性的担忧以及缺乏临床指南导致了NVP管理中的试错情况。我们提出了一种更新的NVP管理算法。

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