DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20190854

Maternal and fetal outcomes in pregnant women with hyperemesis gravidarum

Sangeeta Parihar, Swatantar Singh

Abstract


Background: Hyperemesis gravidarum (HG) is associated with maternal weight loss, nutritional deficiencies, fluid and electrolyte abnormalities, which may lead to adverse fetal and maternal outcomes. The purpose of this study was to evaluate the relationship of hyperemesis gravidarum to maternal and foetal outcomes.

Methods: A hospital-based prospective observational study was carried out. All patients with singleton pregnancy diagnosed as / history of hyperemesis gravidarum the current pregnancy was included in the study. The pregnant women with multiple pregnancy, molar pregnancy, presence of pre-gestational diabetes, pre-gestational hypertension, and other causes of nausea such as appendicitis and pyelonephritis were excluded from the study.

Results: 36 pregnant women with prevalence rate of 3.28% have been found to be suffering from HG. Almost half (17, 47.22%) of the pregnant women with HG had age less than 25 years. The significant association (p-value: 0.0099) has been found between parity and smoking with HG. HG was significantly associated with low birth weight (p-value: 0.0133); small for gestational age (SGA) (p-value: 0.0316); APGAR score < 7 after 1 minute (p-value: 0.0060); and APGAR score <7 after 5 minutes (p-value: 0.0006). There is no association found between mode of delivery, gestational diabetes, and pregnancy-induced hypertension with HG.

Conclusions: HG can adversely affect fetal as well as maternal, though not significant, pregnancy outcomes.


Keywords


Adverse pregnancy outcomes, Fetal outcomes, Hyperemesis gravidarum, Maternal outcomes

Full Text:

PDF

References


Lee NM, Saha S. Nausea and vomiting of pregnancy. Gastroenterol Clin North Am. 2011;40(2):309-34, vii.

Lu QB, Wang ZP, Gao LJ, Gong R, Sun X, Wang M, et al. Nausea and vomiting in early pregnancy and the risk of neural tube defects: a case-control study. Sci Rep. 2015;5:7674.

Jarvis S, Nelson-Piercy C. Management of nausea and vomiting in pregnancy. BMJ 2011;342:d3606.

Attard CL, Kohli MA, Coleman S, Bradley C, Hux M, Atanackovic G, et al. The burden of illness of severe nausea and vomiting of pregnancy in the United States. Am J Obstet Gynecol 2002;186(5):S22-7.

O’Donnell A, McParlin C, Robson SC, Beyer F, Moloney E, Bryant A, et al. Treatments for hyperemesis gravidarum and nausea and vomiting in pregnancy: a systematic review and economic assessment. Health Technol Assess. 2016;20(74):1-26.

World Health Organization (2004) ICD-10, Chapter XV, Pregnancy, childbirth and the puerperium (O00-O99), Other maternal disorders predominantly related to pregnancy (O20-O29). World Health Organization. Available at http://apps.who.int/classifications/apps/icd/icd10online2004/fr-icd.htm?go20.htm+.

London V, Grube S, Sherer DM, Abulafia O. Hyperemesis Gravidarum: A Review of Recent Literature. Pharmacol. 2017;100(3-4):161-71.

Vikanes A, Grjibovski AM, Vangen S, Magnus P. Variations in prevalence of hyperemesis gravidarum by country of birth: a study of 900,074 pregnancies in Norway, 1967-2005. Scand J Public Health. 2008;36(2):135-42.

Veenendaal MV, van Abeelen AF, Painter RC, van der Post JA, Roseboom TJ. Consequences of hyperemesis gravidarum for offspring: a systematic review and meta-analysis. BJOG. 2011;118(11):1302-13.

Bailit JL. Hyperemesis gravidarium: Epidemiologic findings from a large cohort. Am J Obstet Gynecol. 2005;193(3 Pt 1):811-4.

Dodds L, Fell DB, Joseph KS, Allen VM, Butler B. Outcomes of pregnancies complicated by hyperemesis gravidarum. Obstet Gynecol. 2006;107(2 Pt 1):285-92.

Poursharif B, Korst LM, MacGibbon KW, Fejzo MS, Romero R, Goodwin TM. Elective pregnancy termination in a large cohort of women with hyperemesis gravidarum. Contraception 2007;76(6):451-6.

Mazzotta P, Maltepe C, Navioz Y, Magee LA, Koren G. Attitudes, management and consequences of nausea and vomiting of pregnancy in the United States and Canada. Int J Gynaecol Obstet 2000;70(3):359-65.

Eliakim R, AbulaWa O, Sherer DM. Hyperemesis gravidarum: a current review. Am J Perinatol. 2000;17(4):207-18.

Hod M, Orvieto R, Kaplan B, Friedman S, Ovadia J. Hyperemesis gravidarum. A review. J Reprod Med. 1994;39(8):605-12.

Grjibovski AM, Vikanes A, Stoltenberg C, Magnus P. Consanguinity and the risk of hyperemesis gravidarum in Norway. Acta Obstet Gynecol Scand. 2007;87(1):20-5.

Tan PC, Jacob R, Quek KF, Omar SZ. The fetal sex ratio and metabolic, biochemical, haematological and clinical indicators of severity of hyperemesis gravidarum. BJOG. 2006;113(6):733-7.

Matsuo K, Ushioda N, Nagamatsu M, Kimura T. Hyperemesis gravidarum in Eastern Asian population. Gynecol Obstet Invest. 2007;64(4):213-6.

Depue RH, Bernstein L, Ross RK, Judd HL, Henderson BE. Hyperemesis gravidarum in relation to estradiol levels, pregnancy outcome, and other maternal factors: a seroepidemiologic study. Am J Obstet Gynecol. 1987;156(5):1137-41.

Vikanes ÅV, Støer NC, Magnus P, Grjibovski AM. Hyperemesis gravidarum and pregnancy outcomes in the Norwegian Mother and Child Cohort - a cohort study. BMC Pregnancy Childbirth. 2013;13(1):169.

Tsang IS, Katz VL, Wells SD. Maternal and fetal outcomes in hyperemesis gravidarum. Int J Gynaecol Obstet. 1996;55(3):231-5.

Sanu O, Lamont RF. Hyperemesis gravidarum: pathogenesis and the use of antiemetic agents. Expert Opin Pharmacother. 2011;12(5):737-48.

Roseboom TJ, Ravelli AC, van der Post JA, Painter RC. Maternal characteristics largely explain poor pregnancy outcome after hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol. 2011;156(1):56-9.

Kallen B. Hyperemesis during pregnancy and delivery outcome: a registry study. Eur J Obstet Gynecol Reprod Biol. 1987;26(4):291-302.

Fejzo MS, Poursharif B, Korst LM, Munch S, MacGibbon KW, Romero R, et al. Symptoms and pregnancy outcomes associated with extreme weight loss among women with hyperemesis gravidarum. J Womens Health (Larchmt). 2009;18(12):1981-7.

Kuru O, Sen S, Akbayır O, Goksedef BP, Ozsürmeli M, Attar E, et al. Outcomes of pregnancies complicated by hyperemesis gravidarum. Arch Gynecol Obstet. 2012;285(6):1517-21.

Verberg MF, Gillott DJ, Al-Fardan N, Grudzinskas JG. Hyperemesis gravidarum, a literature review. Hum Reprod Update. 2005;11(5):527-39.

Weigel RM, Weigel MM. Nausea and vomiting of early pregnancy and pregnancy outcome. A meta-analytical review. Br J Obstet Gynaecol. 1989;96(11):1312-8.

Gross S, Librach C, Cecutti A. Maternal weight loss associated with hyperemesis gravidarum: a predictor of fetal outcome. Am J Obstet Gynecol. 1989;160(4):906-9.