Interventions Initiated Before and After Pregnancy for Women who Experience Severe Nausea and Vomiting of Pregnancy: A Scoping Review.

INTRODUCTION

Nausea and vomiting of pregnancy (NVP) affects up to 90% of women, while hyperemesis gravidarum (HG), a severe form of NVP, impacts quality of life, and ability to eat and drink normally, with reported recurrence rates up to 89% in subsequent pregnancies. Severe NVP has a profound impact on maternal physical and mental health, impairing daily functioning and quality of life, and is associated with anxiety and depression.

AIMS

To conduct a scoping review to identify and characterise interventions initiated before and after pregnancy that aim to mitigate the impact and consequences of severe NVP on maternal health.

METHODS

A comprehensive search was conducted across seven electronic databases and included grey literature without restrictions on language or date. Eligible studies were identified according to a prespecified criteria. All references were screened independently by two reviewers.

FINDINGS

Three studies were included; two utilised pre-emptive counselling and antiemetic treatment beginning before pregnancy or in early pregnancy/upon recognition of pregnancy, while one focused on post-pregnancy writing therapy. Both pre-emptive interventions reported a reduction in NVP symptom severity and a lower recurrence rate of HG, while writing therapy was beneficial in aiding recovery from severe NVP and allowed women an opportunity to externalise and process the experience.

DISCUSSION

This study revealed a paucity of interventions initiated before and after pregnancy for women with severe NVP. The included studies showed some benefits of pre-emptive treatment and writing therapy.

CONCLUSION

Tailored pre-pregnancy and postpartum interventions for women with previous severe NVP are urgently needed to address the physical and mental health burden of the condition.