Medline ® Abstracts for References 124,125,128
of 'Treatment and outcome of nausea and vomiting of pregnancy'
Hyperemesis during pregnancy and delivery outcome: a registry study.
Eur J Obstet Gynecol Reprod Biol. 1987;26(4):291.
Delivery outcome was studied in 3068 pregnancies with the diagnosis of hyperemesis in the Swedish Medical Birth Registry for the years 1973-1981. This diagnosis was present in a little over 3 per thousand deliveries in the registry but its prevalence varied enormously between different hospitals, from over 1% to practically nil. The diagnosis was over-represented at low maternal age and first parity and when the infant was a girl. Twinning occurred at a significantly increased rate. Gestational length was somewhat shorter and birthweight was lower than expected but this had no effect on perinatal survival. Congenital malformations were present slightly more often than expected and this was due to three diagnoses: undescended testicles, hip dysplasia, and Down syndrome. Possible explanations for this excess are discussed.
Department of Embryology, University of Lund, Sweden.
Hyperemesis gravidarum. Effects on fetal outcome.
Hallak M, Tsalamandris K, Dombrowski MP, Isada NB, Pryde PG, Evans MI
J Reprod Med. 1996;41(11):871.
OBJECTIVE: To study perinatal outcomes in pregnancies complicated by hyperemesis gravidarum (HG) as compared to controls.
STUDY DESIGN: Between 1984 and 1991, 138 patients were diagnosed with HG according to Fairweather's criteria. Subjects were stratified into groups of mild and severe HG according to the presence of at least one of the following criteria: ketonuria, increased blood urea nitrogen and hematocrit, and/or abnormal electrolytes. All patients without HG on whom records were available and who delivered during the study period were included as controls. Multiple gestations and stillbirths were excluded from the analysis. Student's t test and X2 were used for statistical analysis.
RESULTS: Demographic data were not significantly different between the groups. Forty patients were diagnosed as having mild HG and 98 patients as having severe; 12,335 patients were defined as controls. Mean fetal birth weights were 3,110, 3,093, and 3,160 g in the mild, severe and control groups, respectively. The incidence of congenital anomalies was 2.5%, 2.0% and 1.6%, respectively. The incidence of prematurity was 17.5%, 11.2% and 10.7% in mild and severe HG and controls, respectively. None of the outcome variables for mild or severe HG were significantly different as compared to the controls. Differences in other neonatal outcomes, including frequency of five-minute Apgar score<7 and neonatal intensive care unit admissions, were not significantly different between the three groups.
CONCLUSION: In contrast to previous reports, this study demonstrated that fetuses of gravidas admitted for HG are not at increased risk of growth retardation, congenital anomalies or prematurity. No beneficial effect on pregnancy outcome was detected.
Department of Obstetrics and Gynecology, Wayne State University, School of Medicine, Detroit, Michigan, USA.
Is vomiting during pregnancy teratogenic?
Klebanoff MA, Mills JL
Br Med J (Clin Res Ed). 1986;292(6522):724.
The possibility that antiemetics used during pregnancy are teratogenic has been hotly debated; the effect of vomiting itself, however, has been largely ignored. The relation between vomiting and congenital malformations was examined in a prospective study of 16398 women who registered for prenatal care at or before 20 weeks' gestation. The odds ratios for malformations among women who vomited compared with women who did not were 1.14 for major malformations (p = 0.13), 0.88 for deformations (p = 0.39), 1.03 for hernias or undescended testes (p = 0.82), 1.06 for any of these three conditions (p = 0.38), 1.09 for minor anomalies (p = 0.14), and 1.10 for any anomaly (p = 0.03). After adjustment for use of antiemetics and five other confounding variables vomiting was not associated with a significantly increased risk of any of the above malformations. These data suggest that the increased risk, if any, among women receiving antiemetics during pregnancy is due to the drugs, not the vomiting.