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Hyperemesis gravidarum

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Definition:
Anhaltende und starke Übelkeit mit Erbrechen, die vor der 20. SSW beginnt und mit Gewichtsverlust, Exsikkose, Stoffwechselentgleisung und Störungen des Elektrolythaushaltes einhergehen kann.
Häufigkeit:
Kommt bei ca. 1 % aller Schwangeren vor.
Symptome:
Übelkeit gefolgt von Erbrechen und erhöhter Speichelproduktion, die oftmals den gesamten Tag persistiert.
Befunde:
Reduzierter Allgemeinzustand, im Verlauf Entwicklung von Gewichtsabnahme, Exsikkose und Elektrolytstörungen.
Diagnostik:
Labor und Sonografie.
Therapie:
Die meisten Schwangeren mit Emesis gravidarum können ohne Medikamente behandelt werden, handelt es sich jedoch um eine Hyperemesis gravidarum nach o. g. Definition sind Medikamente und oftmals ein stationärer Aufenthalt indiziert.
  1. Prof Dr. med. Harald Abele. Hperemesis gravidarum. Gynkongress 2016; 4: 2. www.dggg.de  
  2. Niebyl JR. Clinical practice. Nausea and vomiting in pregnancy. N Engl J Med 2010; 363:1544-50 doi: 10.1056/NEJMcp1003896 DOI  
  3. Ioannis Mylonas, Andrea Gingelmaier, Franz Kainer. Erbrechen in der Schwangerschaft. Deutsches Ärzteblatt 2007; 25: 1821–6. www.aerzteblatt.de  
  4. Buckwalter, JG, Simpson, SW. Psychological factors in the etiology and treatment of severe nausea and vomiting in pregnancy. Am J Obstet Gynecol 2002; 186:S210. PubMed  
  5. Vikanes A, Skjaerven R, Grjibovski AM, Gunnes N, Vangen S, Magnus P. Recurrence of hyperemesis gravidarum across generations: population based cohort study. BMJ 2010; 340:c2050. www.bmj.com  
  6. Golberg D, Szilagyi A, Graves L. Hyperemesis gravidarum and Helicobacter pylori infection: a systematic review. Obstet Gynecol 2007; 110: 695-703. PubMed  
  7. Eliakim R, Abulafia O, Sherer DM. Hyperemesis gravidarum: a current review. Am J Perinatol 2000; 17: 207-18 PubMed  
  8. Vilming B, Nesheim B-I. Hyperemesis gravidarum in a contemporary population in Oslo. Acta Obstet Gynecol Scand 2000; 79: 640-3. PubMed  
  9. Fell, DB, Dodds, L, Joseph, KS, et al. Risk factors for hyperemesis gravidarum requiring hospital admission during pregnancy. Obstet Gynecol 2006; 107:277. PubMed  
  10. Boneva, RS, Moore, CA, Botto, L, et al. Nausea during pregnancy and congenital heart defects: a population-based case-control study. Am J Epidemiol 1999; 149:717. pubmed.ncbi.nlm.nih.gov  
  11. Abell, T, Riely, C. Hyperemesis gravidarum. Gastroenterol Clin North Am 1992; 21:835. PubMed  
  12. Kimura, M, Mino, N, Tamaki, H, et al. Gestational thyrotoxicosis and hyperemesis gravidarum: Possible role of hCG with higher stimulating activity. Clin Endocrinol 1993; 38:345. pubmed.ncbi.nlm.nih.gov  
  13. Newman, V, Fullerton, JT, Anderson, PO. Clinical advances in the management of severe nausea and vomiting during pregnancy. J Obstet Gynecol Neonatal Nurs 1993; 22:483. PubMed  
  14. Jednak, MA, Shadigian, EM, Kim, MS, et al. Protein meals reduce nausea and gastric slow wave dysrhythmic activity in first trimester pregnancy. Am J Physiol 1999; 277:G855. PubMed  
  15. Heinrichs, L. Linking olfaction with nausea and vomiting of pregnancy, recurrent abortion, hyperemesis gravidarum, and migraine headache. Am J Obstet Gynecol 2002; 186:S215. PubMed  
  16. Association of professors of gynecology and obstetrics. Nausea and vomiting of pregnancy. Association of professors of gynecology and obstetrics, Washington, DC 2001.
  17. McParlin C, O'Donnell A, Robson SC, et al. Treatments for Hyperemesis Gravidarum and Nausea and Vomiting in Pregnancy: A Systematic Review. JAMA 2016 Oct 4; 316(13): 1392-1401. pmid:27731292 PubMed  
  18. Matthews A, Haas DM, O'Mathúna DP, Dowswell T, Doyle M. Interventions for nausea and vomiting in early pregnancy. Cochrane Database of Systematic Reviews 2014, Issue 3. Art. No.: CD007575. DOI: 10.1002/14651858.CD007575.pub3 DOI  
  19. Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie, Hyperemesis gravidarum/Emesis gravidarum. 05/2021. www.embryotox.de  
  20. arznei-telegramm: Antiemetische Therapie bei Schwangerschaftserbrechen. a-t 2009; 40: 87-89 www.arznei-telegramm.de  
  21. Boelig RC, Barton SJ, Saccone G, Kelly AJ, Edwards SJ, Berghella V. . Interventions for treating hyperemesis gravidarum. Cochrane Database of Systematic Reviews 2016; Issue 5: Art. No.: CD010607. pmid:27168518 PubMed  
  22. Pasternak B, Svanström H, Mølgaard-Nielsen D, et al. Metoclopramide in pregnancy and risk of major congenital malformations and fetal death. JAMA 2013; 310: 1601-11. doi:10.1001/jama.2013.278343 DOI  
  23. Bundesinstitut für Arzneimittel und Medizinprodukte. Rote-Hand-Brief zu Ondansetron: Erhöhtes Risiko orofazialer Fehlbildungen bei der Anwendung im ersten Trimenon der Schwangerschaft. Berlin, 1.10.2019. www.bfarm.de  
  24. Huybrechts KF, Hernández-Días S, Straub L, et al. Association of Maternal First-Trimester Ondansetron Use With Cardiac Malformations and Oral Clefts in Offspring. JAMA 2018; 320: 2429-37. pmid:30561479 www.ncbi.nlm.nih.gov  
  25. Danielsson B, Wikner BN, Källén B. Use of ondansetron during pregnancy and congenital malformations in the infant. Reprod Toxicol 2014; 50: 134-7. pmid:25450422 PubMed  
  26. Pasternak B, Svanström H, Hviid A. Ondansetron in pregnancy and risk of adverse fetal outcomes. N Engl J Med 2013; 368: 814-823. New England Journal of Medicine  
  27. Safari HR, Fassett MJ, Souter IC, Alsulyman OM, Goodwin TM. The efficacy of methylprednisolone in the treatment of hyperemesis gravidarum: a randomized, double-blind, controlled study. Am J Obstet Gynecol 1998;179:921-4. PubMed  
  28. Quinlan JD, Hill DA. Nausea and vomiting of pregnancy. Am Fam Physician 2003; 68: 121-8. American Family Physician  
  29. Knight, B, Mudge, C, Openshaw, et al. Effect of acupuncture on nausea of pregnancy: a randomized, controlled trial. Obstet Gynecol 2001; 97:184. PubMed  
  30. Tierson, FD, Olsen, CL, Hook, EB. Nausea and vomiting of pregnancy and association with pregnancy outcome. Am J Obstet Gynecol 1986; 155:1017. PubMed  
  31. Chiossi, G, Neri, I, Cavazzuti, M, et al. Hyperemesis gravidarum complicated by wernicke encephalopathy: background, case report, and review of the literature. Obstet Gynecol Surv 2006; 61:255. PubMed  
  32. Trogstad, LI, Stoltenberg, C, Magnus, P, et al. Recurrence risk in hyperemesis gravidarum. BJOG 2005; 112:1641. PubMed  
  33. Heitmann K, Nordeng H, Havnen GC, Solheimsnes A, Holst L. The burden of nausea and vomiting during pregnancy: severe impacts on quality of life, daily life functioning and willingness to become pregnant again – results from a cross-sectional study. BMC Pregnancy Childbirth 2017; 17: 75. pmid:28241811 PubMed  
  34. Whitehead SA, Andrew PLR, Chamberlain GVP. Characterisation of nausea and vomiting in early pregnancy: a survey og 1000 women. J Obstet Gynaecol 1992; 12: 364-9. www.tandfonline.com  
  35. Smith C, Crowther C, Beilby J, Dandeaux J. The impact of nausea and vomiting on women: a burden of early pregnancy. Australian & New Zealand Journal of Obstetrics & Gynaecology 2000; 40: 397-401. pubmed.ncbi.nlm.nih.gov  
  36. Dodds, L, Fell, DB, Joseph, KS, et al. Outcomes of pregnancies complicated by hyperemesis gravidarum. Obstet Gynecol 2006; 107:285. PubMed  
  • Kristine Scheibel, Dr. med. Fachärztin für Allgemeinmedizin, Norderney