ประมาณ 50% ของผู้หญิงมีอาการคลื่นไส้อาเจียนในการตั้งครรภ์ในช่วงต้นและแก้ที่ดีนอกจากAbout 50% of women have nausea and vomiting in early pregnancy, and an addi-
tional 25% มีอาการคลื่นไส้เพียงอย่างเดียว 1,2 คำนิยม "แพ้ท้อง" เป็น misno- tional 25% have nausea alone. 1,2 The popular term “morning sickness” is a misno-
ทะเลเนื่องจากภาวะนี้มักจะยังคงมีอยู่ตลอดทั้งวัน 2 ประมาณ 35% ของ wom- ห้องน้ำที่มีสภาพนี้อาการคลื่นไส้อาเจียนมีความสำคัญทางคลินิกที่เกิดขึ้นในเวลาทำงานหายไปและส่งผลกระทบต่อความสัมพันธ์ในครอบครัว 3,4 ใน minor- เล็กity ของผู้ป่วยอาการนำไปสู่การคายน้ำและการสูญเสียน้ำหนักต้อง hospi- talization 5 อุบัติการณ์ของการรายงาน hyperemesis gravidarum เป็น 0.3-1.0%; mer, since this condition often persists throughout the day. 2 In about 35% of wom-
en who have this condition, nausea and vomiting are clinically significant, resulting
in lost work time and negatively affecting family relationships. 3,4 In a small minor-
ity of patients, the symptoms lead to dehydration and weight loss requiring hospi-
talization. 5 The reported incidence of hyperemesis gravidarum is 0.3 to 1.0%; this
condition is characterized by persistent vomiting, weight loss of more than 5%,
ketonuria, electrolyte abnormalities (hypokalemia), and dehydration (high urine
specific gravity). 5,6
Although the cause of nausea and vomiting in pregnancy is unclear, the obser-
vation that pregnancies with a complete hydatidiform mole (no fetus) are associ-
ated with clinically significant nausea and vomiting indicates that the stimulus is
produced by the placenta, not the fetus. The onset of the nausea is within 4 weeks
after the last menstrual period in most patients. The problem typically peaks at
approximately 9 weeks of gestation. Sixty percent of cases resolve by the end of
the first trimester, and 91% resolve by 20 weeks of gestation. 1 Nausea and vomit-
ing are less common in older women, multiparous women, and smokers; this
observation has been attributed to the smaller placental volumes in these women.
In one study, 63% of multiparous women who had nausea and vomiting also had
symptoms in a previous pregnancy. 1 Nausea and vomiting are associated with a
decreased risk of miscarriage. 7
The clinical course of nausea and vomiting during pregnancy correlates closely
with the level of human chorionic gonadotropin (hCG) (Fig. 1). 8 It is theorized that
hCG may stimulate estrogen production from the ovary; estrogen is known to
increase nausea and vomiting. Women with twins or hydatidiform moles, who
have higher hCG levels than do other pregnant women, are at higher risk for these
symptoms. Another theory is that vitamin B deficiency may contribute, since the
use of multivitamins containing vitamin B reduces the incidence of nausea and
vomiting. Although it has been suggested that nausea and vomiting may be caused
by psychological factors, there are no good data to support this.
Preventable rare maternal complications of hyperemesis gravidarum include
การแปล กรุณารอสักครู่..
