Helicobacter pylori seropositivity In hyperemesis gravidarum during pregnancy

Background: Prevalence of hyperemesis gravidarum varies from 0.3 to 1.5% of all live births. The exact cause is not well known and is probably multifactorial. It is the most common cause of hospitalization in the first half of pregnancy and second only to preterm labor for pregnancy overall. The etiology of emesis gravidarum remains unknown. But a number of possible causes have been studied as endocrinal, immunological, psychological, metabolic, genetic and even infectious such as helicobacter pylori infection. Aim of the Work: To assess the value of screening for helicobacter pylori seropositivity in hyperemesis gravidarum for better evaluating and improving the cure rate especially in resistant cases. Patients and methods: A prospective controlled comparative study was conducted on 100 pregnant women in the first trimester, where 50 of them were suffering from hyperemesis gravidarum (group A) and another 50 healthy women were chosen as a control group (group B). They were recruited from the outpatient clinic of Al-Galaa Maternity Teaching Hospital, Cairo, Egypt from January 2019 till August 2019. After approval of the local ethics committee, a written consent was obtained from each woman before inclusion in the study. Fasting and post prandial sugar, Liver and kidney function tests, thyroid function tests, CBC, urine and electrolyte examination as well as serum examination for IgG of helicobacter pylori were done for each one. Results: Serum helicobacter pylori IgG antibodies seropositivity and acetonuria was significantly higher in group A than in group B while serum sodium and potassium levels were significantly lower in patients with hyperemesis gravidarum than control group. Conclusion: The treatment of H. Pylori infection may reduce the risk of hyperemesis gravidarum and its complications

Quality Characteristics of Ginger Extract Candy with Salicornia herbacea L. for Calming Effect on Morning Sickness

The primary objective of this study was to develop an optimal composite recipe for ginger extract candy with Salicornia herbacea L., for consumption during the first trimester of pregnancy. The secondary objective was to examine quality characteristics of the candy. The physical and mechanical properties and sensory properties for pregnant women in were measured, and these values were applied to mathematical models. Time of stirring water solution, saltiness, pH, and redness of the candy increased as concentrations of ginger juice did, but variations in pH were not significant. The hardness values of the candy ranged from 3,063.90 to 5,681.65 dyne/cm³. The average values of sweetness and time stirring the water solution were 5.36% and 14.1 minutes, respectively. However, hardness and sweetness stirring water solution were not significant. The range of sensory values of color (P < 0.01), flavor (P < 0.05), sweetness, saltiness, spiciness, and overall quality (P < 0.05) ranged from were 3.73~5.32, 4.05~5.05, 3.67~5.14, 3.59~5.09, 3.55~5.15, and 3.32~5.45, respectively. Results suggest that ginger extract candy with Salicornia herbacea L. should be comprised of 7.37 g of ginger juice and 1.77 g of salt. Consequently, it could be a functional candy for pregnant women.

Systematic review of the effect of dried ginger powder on improvement of nausea and vomiting associated with early pregnancy or motion sickness / 한국영양학회지

PURPOSE: Ginger (Zingiber officinale) has been widely used as an antiemetic agent. This systematic review was aimed at evaluation of the effect of dried ginger powder supplementation on improvement of nausea and vomiting associated with early pregnancy or motion sickness. METHODS: We searched Pubmed, Cochrane, Science Direct, and KISS (Korean studies Information Service System) using keywords such as ginger or Zingiber officinale in combination with nausea, vomiting, motion sickness, or pregnancy, published in March 2013. RESULTS: The strength of the evidence was evaluated on the selected 12 RCTs (randomized controlled trials). Eleven trials including 2,630 subjects showed that supplementation with dried ginger powder resulted in significant improvement of nausea or vomiting related to early pregnancy or motion sickness. Among the nine studies including 809 women in early pregnancy before 20 weeks of gestation, ginger supplementation was superior to placebo in five studies (n = 305), and as effective as positive control (vitamin B6 or dimenhydrinate) in four studies (n = 504). Ginger intake significantly reduced the episodes or severity of vomiting related to motion sickness compared to placebo or showed the same effect as several antiemetic drugs in two studies (n = 1,821). CONCLUSION: Our findings added evidence indicating that ginger powder supplements might improve the symptoms of nausea or vomiting related to early pregnancy or motion sickness without significant adverse events.

Compliance with the Protocol Considered Emetogenic Potential for Prophylaxis of Chemotherapy Induced Nausea and Vomiting / 종양간호학회지

PURPOSE: The purpose of this study was to identify the compliance with the protocol, which was developed considering the emetogenic potential for prophylaxis of chemotherapy. METHODS: Data was collected from 144 patients who received chemotherapy from June 15 to August 31, 2010 in C University Hospital in Jeollanamdo, Korea. The level of chemotherapy-induced nausea and vomiting (CINV) and the compliance with the protocol for prophylaxis of CINV were measured. RESULTS: There was statistically significant difference of CINV in morning sickness and anticipatory nausea of general and clinical characteristics. Also, the compliance with the protocol developed according to emetogenic potential of chemotherapy was statistically significant. There was no difference in CINV in regard to the compliance with the protocol. CONCLUSION: There was a good compliance with the protocol for prophylaxis according to emetogenic potential. But it should be recommended to use antiemetics for prophylaxis aggressively to relieve CINV for the patients who already experienced morning sickness and anticipatory nausea. In addition, the oncology nurses should respond sensitively to the complaints of nausea and vomiting no matter what the emetogenic potentials of chemotherapy regimen are.

The Possibility of Morning Sickness from Olfactory Hypersensitivity during Pregnancy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Nausea and vomiting in early pregnancy are well-known phenomena. It has been suggested that the mechanism that triggers nausea and vomiting in pregnancy may be related to olfactory changes. We planned to investigate olfactory function changes and the relationship between olfaction changes and nausea and vomiting in early pregnancy. SUBJECTS AND METHODS: Two groups of participants with the total of 75 women (35 pregnant women; 40 non-pregnant women) were analyzed prospectively. Objective olfactory function was tested using Korean Version of Sniffin' Sticks-II test (KVSS-II test). In addition, pregnant subjects were investigated using the questionnaire to evaluate the severity of nausea and vomiting, and whether the changes were due to olfactory sensitivity. RESULTS: Subjective olfactory sensitivity was increased in pregnant subjects. However, there was no significant difference in the objective olfactory function between the two groups. CONCLUSION: Based on this study, we concluded that pregnancy is accompanied by changes in subjective olfactory sensitivity and higher subjective olfactory discomfort. But these findings do not support the hypothesis that nausea and vomiting is dependent of the changes in the objective olfactory function during early pregnancy.

Gengibre / Ginger

Introdução: O gengibre predomina no receituário popular como bom para a digestão, gripes e resfriados na forma de infusão para ingestão ou gargarejo. Na indicação médica formal, praticamente ele inexiste. Objetivo: Encontrar, na literatura científica, estudos com boa qualidade metodológica que deem subsídios para umaindicação precisa do uso do gengibre na saúde.Métodos: Foram procurados inicialmente estudos com melhor grau de evidência na Colaboração Cochrane e, depois,nas bases Medline, Lilacs, PubMed, procurando destacar os estudos com melhor qualidade metodológica.Resultados: Encontramos três revisões sistemáticas na Colaboração Cochrane e dezenas de estudos randomizados nas outras fontes de buscas, focalizando principalmente os efeitos sobre náuseas e vômitos na gravidez, com resultados satisfatórios na maioria deles. Dois estudos focaram esses mesmos desfechos em pacientes submetidos à quimioterapia e na cirurgia ginecológica. Um estudo focou a asma, outro estudo focou a osteartrite e outro focoua dislipidemia. Dois estudos realizados em voluntários sadios trataram sobre a influência do gengibre na gastriteesofágica e gástrica. Os resultados que podem ser considerados relevantes foram em gestantes na prevenção de náusease vômitos da gravidez. Os demais foram estudos isolados que, embora relevantes, não têm poder estatístico suficiente para gerar evidência.Conclusão: O gengibre pode ser incorporado como um importante adjuvante na prevenção de náuseas e vômitos, antes de lançarmos mão de medidas terapêuticas alopáticas convencionais. As demais indicações carecem de trabalhos.

Metoclopramida é segura na gravidez

A metoclopramida, se usada no primeiro trimestre da gesðtação, não está associada a aumento do risco de baixo peso em recém-nascidos, parto pré-termo, malformações ou morte peðrinatal. Nível de evidência: 2b = estudo comparativo de baixa quaðlidade metodológica.

Morning Sickness of Pregnancy / 대한주산의학회잡지

Morning sickness is a common condition in early pregnancy, and it affects the health of both the pregnant woman and fetus. It can decrease the woman's quality of life and also contribute significantly to health care costs and time off work. In most women the condition is mild and self limiting, but a small percentage of women experience severe form being hyperemesis gravidarum. Once symptoms progress, treatment can become more difficult. So, the treatment in the early stages is important to prevent more serious complications, including hospitalization. Once pathologic causes have been ruled out, treatment is individualized. Initial treatment should be conservative and should involve dietary and lifestyle changes. But, severe or prolonged cases may need hospitalization and pharmacologic therapy.

Efficacy and safety of ginger to reduce nausea and vomiting of pregnancy: a systematic review and meta-analysis

To assess the efficacy and safety of ginger [rhizome of Zingiber officinale] to reduce severity of nausea and numbers of vomiting in early pregnancy. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL and SID databaseswere searched for relevant sources. Randomized trials of oral ginger in comparison with placebo for nausea and/or vomiting in early pregnancy were selected. Two reviewers assessed the trial quality and extracted the data independently. Five trials met the inclusion criteria to assess the efficacy. Based on these trials, there was a significant reduction in severity of nausea after taking ginger compared with placebo [Pooled SMD= 0.882, 90% confidence interval 0.267 to 1.496]. Also there was similar effect in reducing number of vomiting [Pooled SMD= 0.631, 90% confidence interval 0.433 to 0.829]. In addition, there were 5 trials or observational studies which had assessed the potential fetomaternal side effects of ginger. There was no supporting evidence for increasing pregnancy complications after using Ginger. Based on the current evidences, Ginger reduces the severity of nausea and frequency of vomiting in early pregnancy. There are considerations about adverse effects, but they are not supported by the clinical evidence. It seems that ginger could be used during pregnancy in therapeutic doses [almost 1 gr per day] for limited durations

Effect of acupressure by sea-bands on nausea and vomiting of pregnancy

To determine the effect of continuous acupressure at P6.applied by Sea-Bands with acupressure buttons on the frequency and severity of nausea and vomiting of pregnancy during the 8-20 weeks. A two-group quasi-experimental posttest-only and posttest-repeated measure in seventeen medical clinics or offices in southern Tehran was carried out. A convenience sample of Persian-speaking; healthily pregnant women in their 8-20 weeks of pregnancy; who had at least one episode of nausea, vomiting, or both before their prenatal clinic/ office visit where they were recruited. The women were randomly assigned to treatment or placebo groups. Treatment group [1] applied Sea-Bands with acupressure buttons to both wrists for 4 days and removed the Sea-Bands for 3 subsequent days. Placebo group [2] applied the Sea-Bands with out acupressure buttons to both wrists on the same time schedule as group 1. Self-reported daily diaries of the number of times per day that participants experienced nausea, the severity of nausea, the number of vomiting episodes per day, and the severity of vomiting were recorded. Mann-Whitney U test revealed that the treatment group had significantly less frequency and severity of nausea and vomiting of pregnancy while wearing the Sea-Bands than did the placebo group. The treatment group also had significantly less frequency and severity of nausea and vomiting of pregnancy while wearing the Sea-Bands than when not wearing the Sea-Bands. Sea-Bands with acupressure buttons are a noninvasive, inexpensive, safe, and effective treatment for the nausea and vomiting of pregnancy

Clinical study of Jawarish Anarain in vomiting during pregnancy

Morning sickness or simple emesis along with nausea is commonly present in 50% ladies during their pregnancy upto 12-14 weeks but when it becomes severe, it is called as hyperemesis gravidarum which exerts deleterious effects on the health of mother as well as of the baby. It may be a symptom of various medical-surgical-gynaecological complications and if it is not controlled in its early phase sometimes a hard decision of termination of pregnancy has to be undertaken. The guideline for treating ailments during pregnancy is first that the drug should be safe not to hinder with the continuation of gestation period. In this protective mode of treatment, our Unani herbal formulations have proved their superiority over the drugs of other systems. Present study was carried out to assess the efficacy of Jawarish Anarain in vomiting during pregnancy and results found were very encouraging

Características socioculturales y demográficas asociadas a las gestantes que presentan náuseas y vómitos e hiperemesis gravídica / Sociocultural and demographic features associated with pregnant women that present sickness and vomits, and hyperemesis gravidarum

Se realizó un trabajo descriptivo, exploratorio en el Hospital San José del Callao, con la finalidad de determinar las características socioculturales y demográficas asociadas a las gestantes que presentan náuseas y vómitos, e hiperemesis gravídica. En el trabajo se pudo encontrar que la hiperemesis así como las nauseas y vómitos se presentaron con mayor frecuencia en mujeres de 20 a 35 años, siendo la mayoría de ellas procedentes de Lima. Generalmente vivían con su esposo, más de la mitad eran amas de casa, teniendo la mayoría casa propia y más de las tres cuartas partes un ingreso familiar mensual de entre 200 y 500 soles.

A descriptive, exploratory job at the Hospital San José of the Callao with the purpose to determine the characteristic social, was accomplished and cultural and demographic associates to the pregnant women that they present sickness and vomits, and Hiperemesis gravidarum. At work she could meet than the Hiperemesis the same way that sickness and vomits presented with bigger frequency in women of 20 to 35 years themselves, being the majority of appropriate women of Lima, and generally they lived with his husband, being in over the half of cases householders, having most things marry own, having a family entrance from among 200 and 500 soles in over the three fourth parts of women.

Common Functional Problems during Pregnancy and Association with Nutritional Status and Weight of Newborns / 대한지역사회영양학회지

Morning sickness during pregnancy is a very common functional problem with different kinds of symptom, but little data are available concerning the nutrition intervention program for pregnant women in local area. A total of 152 pregnant women who had experienced morning sickness were surveyed to investigate the relationships between morning sickness, nutrient intakes and pregnancy outcome. The results showed that prevalent symptoms were nausea (68.4%), heartburn (59.2%), morning sickness (48.7%), vomiting (42.1%), and constipation (44.7%). The onset of the symptom occurred during the first 3 months (9.3 +/- 2.3 weeks); 21.1% of the subjects was experienced two symptom at the same time. This significantly correlated with vomiting (p < 0.01), nausea (p < 0.001), morning sickness (p < 0.001), and heartburn (p < 0.01) with pregnancy weight. There were also correlations between the four symptoms and nutrient intakes. Mean birth weight of 21 newborns was 3.06 +/- 0.42 kg, and the one and five minutes of Apgar scores were 7.74 +/- 0.99 and 8.84 +/- 0.69, respectively. There were negative correlations between vomiting and pregnancy outcomes (p < 0.05). Our data support that morning sickness, especially vomiting during pregnancy is associated with Apgar score and body weight of newborn.

A Screening Tool for Identifying High-Risk Pregnant Women of Fe Deficiency Anemia : Process I / 대한지역사회영양학회지

Iron deficiency anemia is a worldwide public health problem relevant to unsound nutritional practice. While the prevalence of iron deficiency anemia is very common among pregnant women, appropriate nutritional service programs to improve the iron status are lacking in Korea. In an attempt to develop a nutritional screening tool to separate the high-risk subjects of iron deficiency, we carried out a nutritional survey for 115 Korean pregnant women whose gestational age ranged from 13 to 24 weeks. Each subject was interviewed with questionnaires for general characteristics and dietary habits. Food intake was measured by 24-hour recap method and 2 day record. Fasting blood was drawn for measuring hemoglobin and serum ferritin. It appeared that half of the pregnant women belonged to the anemia group and had insufficient dietary habits to provide adequate amounts of dietary iron. The first gravida and the working women had better hematological iron indicators than the second or more gravida and the housewives. It also appeared that women who had bigger family size and lower BMI in pre-pregnancy had poorer iron status. Among the food consumption habits, fruit dependent dietary habit was related to poor iron status. Sufficiently consumed green leafy vegetable and appropriate amount of food before morning sickness were positive factors of iron stares. Our results indicated that parity, BMI, current job, family size, food habits including consumption of fruits, green & yellow vegetables, and food habits before the onset of morning sickness are significant factors to contribute the Fe deficiency anemia during pregnancy.

Thyroid Hormone in Hyperemesis Gravidarum / 대한산부인과학회잡지

Nausea and vomiting during early pregnancy is a common phenomenon, but very little data is available about the mechanism of this condition, and the etiology of hypereme sis is still unknown. One of the most popular hypothesis is that abnormal hormone levels, especi-ally thyroid hormone, may be possible etiologic factor of nausea and vomiting. The object of this study is to investigate the relationship between the presence or ab- sence of nausea and vomiting in early pregnancy and thyroid function. Twenty patients suffering from hyperemesis gravidarum of first trimester of pregnancy and twenty from morning sickness were selected. 20 non-pregnant and 20 pregnant women without nausea and vomiting were selected to age-matched control groups. Thyroid function was evaluated by using T3, T4, and TSH radioimmunoassay. Comparison between groups were analyzed with the paired t-test. In this study, we found that a significant increase in serum total T4(p<0.001) and T3 (p<0.05), and a significant decrease in serum TSH(p<0.001) were observed in pregnancy with hyperemesis gravidarum relative to the level in normal pregnancy. These results were correlated with the severity of nausea and vomiting. In conclusion, highly elevated T3 and T4 were closely linked to the cause of the vomi- ting in pregnancy with hyperemesis gravidarum. Further study is needed to evaluate more clearly the thyroid status of patients with hyperemesis gravidarum and to seek a therapy.