morning sickness (nausea & vomiting of pregnancy)
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Epidemiology
- may affect over 1/2 of pregnancies
Pathology
- fetal production of GDF15, & maternal sensitivity to GDF15, contribute to nausea & vomiting of pregnancy
Clinical manifestations
Complications
- morning sickness associated with reduced risk for miscarriage[6]
Management
- frequent, small meals of bland food
- vitamin B6 12.5 to 25 mg TID-QID
- add doxylamine 12.5 mg with each B6 dose if B6 alone is not enough to relieve nausea[2]
- combination doxylamine/pyridoxine (Diclegis) FDA-approved in 2013[3]
- may not be as effective as previously reported[7]
- combination doxylamine/pyridoxine (Diclegis) FDA-approved in 2013[3]
- ginger, up to 1 g/day of ginger supplements without obvious problems
- metoclopramide[4][5]
More general terms
Additional terms
References
- ↑ Prescriber's Letter 16(11): 2009 COMMENTARY: Is Ginger Safe For Use During Pregnancy? GUIDELINES: AGA Position Statement on the Use of Gastrointestinal Medications in Pregnancy GUIDELINES: ACOG Practice Bulletin on Nausea and Vomiting of Pregnancy Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=251108&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 2.0 2.1 Koren G et al. Effectiveness of delayed-release doxylamine and pyridoxine for nausea and vomiting of pregnancy: A randomized placebo controlled trial. Am J Obstet Gynecol 2010 Dec; 203:571.e1. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20843504
- ↑ 3.0 3.1 FDA News Release: April 8, 2013 FDA approves Diclegis for pregnant women experiencing nausea and vomiting. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm347087.htm
- ↑ 4.0 4.1 Matok I et al, The Safety of Metoclopramide Use in the First Trimester of Pregnancy PMID: https://www.ncbi.nlm.nih.gov/pubmed/19516033 N Engl J Med 2009 (June 11) 360:2528-2535
- ↑ 5.0 5.1 Pasternak B et al Metoclopramide in Pregnancy and Risk of Major Congenital Malformations and Fetal Death. JAMA. 2013;310(15):1601-1611 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24129464 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1752754
- ↑ 6.0 6.1 Hinkle SN, Mumford SL, Grantz KL et al Association of Nausea and Vomiting During Pregnancy With Pregnancy Loss. A Secondary Analysis of a Randomized Clinical Trial. JAMA Intern Med. Published online September 26, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27669539 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=2553283
- ↑ 7.0 7.1 Persaud N, Meaney C, El-Emam K, Moineddin R, Thorpe K. Doxylamine-pyridoxine for nausea and vomiting of pregnancy randomized placebo controlled trial: Prespecified analyses and reanalysis. PLOS One. January 17, 2018 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29342163 Free full text <Internet> http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0189978
- ↑ NEJM Knowledge+
Niebyl JR Clinical practice. Nausea and vomiting in pregnancy. N Engl J Med. 2010 Oct 14;363(16):1544-50. doi:http://dx.doi.org/ 10.1056/NEJMcp1003896. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20942670 Review. No abstract available. https://www.nejm.org/doi/pdf/10.1056/NEJMcp1003896
Committee on Practice Bulletins-Obstetrics ACOG Practice Bulletin No. 189: Nausea And Vomiting Of Pregnancy. Obstet Gynecol. 2018 Jan;131(1):e15-e30. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29266076 - ↑ Fejo M, Rocha N, Cimino I et al GDF15 linked to maternal risk of nausea and vomiting during pregnancy. Nature. 2-23. Dec 13. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38092039 https://www.nature.com/articles/s41586-023-06921-9