Joshi Arushi, Chadha Garima, Narayanan Palaniappan
Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Emergency Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Cureus. 2023 Aug 23;15(8):e44004. doi: 10.7759/cureus.44004. eCollection 2023 Aug.
Hyperemesis gravidarum (HG) is a severe and debilitating condition characterized by persistent and excessive nausea and vomiting during pregnancy (NVP), often leading to significant maternal and fetal morbidity. This literature review aims to provide a scientifically comprehensive overview of HG within the context of the emergency room (ER) setting. This review aims to enhance understanding and improve the management of HG cases presented to the ER by synthesizing current knowledge and evidence-based practices. This literature review encompasses a systematic analysis of relevant scientific literature, encompassing original research studies, review articles, and clinical guidelines. An extensive search of electronic databases was conducted, covering the period from January 2003 to January 2023. Keywords related to HG, pregnancy-related complications, emergency medicine, and ER management were employed to identify pertinent publications. Through the literature review, we found the incidence of HG-related ER admission to be 0.8%. Although the etiology of HG remains to be unknown, a strong association was found between developing HG in pregnant females and a history of gastrointestinal (GI) disorders, use of cannabis, and pregnancies conceived through artificial reproductive technology (ART). Furthermore, overweight females were more likely to develop HG. Maternal smoking was found to be protective against HG. The symptoms of HG mainly include intractable nausea and vomiting occurring usually between four and nine weeks of gestational age with a significant aversion to food and loss of weight. Diagnosis is done through a strong clinical suspicion, a history of HG in previous pregnancies, and a basic metabolic panel. Treatment includes intravenous (IV) fluids, antiemetic therapy, corticoids, thiamine supplements, and laxatives. In our review, we highlight a few complications that can be seen in HG through a synopsis of unique case reports found during our literature search. In conclusion, through this review, we wish to highlight HG as an obstetrical emergency. We aim to improve understanding, enhance early recognition, and promote evidence-based management strategies for HG in the emergency room. We hope that the findings presented herein will serve as a valuable resource for healthcare professionals, researchers, and policymakers involved in the care of pregnant females experiencing HG in the ER.
妊娠剧吐（HG）是一种严重且使人虚弱的病症，其特征为孕期出现持续性和过度的恶心与呕吐（NVP），常导致母婴出现显著的发病情况。本综述旨在在急诊室（ER）环境背景下，对妊娠剧吐进行科学全面的概述。本综述旨在通过综合当前知识和循证实践，增进对急诊室中出现的妊娠剧吐病例的理解并改善其管理。本综述涵盖了对相关科学文献的系统分析，包括原创研究、综述文章和临床指南。对电子数据库进行了广泛检索，涵盖2003年1月至2023年1月期间。使用与妊娠剧吐、妊娠相关并发症、急诊医学和急诊室管理相关的关键词来识别相关出版物。通过文献综述，我们发现因妊娠剧吐而入住急诊室的发生率为0.8%。尽管妊娠剧吐的病因尚不清楚，但发现怀孕女性发生妊娠剧吐与胃肠道（GI）疾病史、使用大麻以及通过辅助生殖技术（ART）受孕之间存在密切关联。此外，超重女性更易发生妊娠剧吐。发现孕妇吸烟对妊娠剧吐有预防作用。妊娠剧吐症状主要包括通常在孕龄4至9周之间出现的顽固性恶心和呕吐，伴有对食物的强烈厌恶和体重减轻。诊断通过强烈的临床怀疑、既往妊娠剧吐病史以及基础代谢指标进行。治疗包括静脉输液、止吐治疗、皮质类固醇、硫胺补充剂和泻药。在我们的综述中，通过对文献检索中发现的独特病例报告进行概述，突出了妊娠剧吐中可能出现的一些并发症。总之，通过本综述，我们希望强调妊娠剧吐是一种产科急症。我们旨在增进理解、加强早期识别，并推广急诊室中妊娠剧吐的循证管理策略。我们希望本文呈现的研究结果能为参与急诊室中患有妊娠剧吐的孕妇护理工作的医护人员、研究人员和政策制定者提供有价值的资源。
