SOP Nausea, Emesis und Hyperemesis gravidarum

Eine Hyperemesis gravidarum (HG) entwickelt sich in 0,5 – 3,6% der Schwangerschaften und ist neben Übelkeit mit schwerem und wiederholtem Erbrechen verbunden. Sie persistiert selten über das 1. Trimenon hinaus. Der Schweregrad lässt sich z. B. mit dem PUQE-Score einteilen. Die Behandlung sollte möglichst früh beginnen. Sie umfasst neben einer Ernährungsumstellung und alternativen Ansätzen eine stadiengerechte Therapie.

Schlüsselwörter

Nausea - Erbrechen - Schwangerschaft - Emesis - Hyperemesis gravidarum - PUQE-Index

• Literatur

• 1 Einarson TR, Piwko C, Koren G. Quantifying the global rates of nausea and vomiting of pregnancy: a meta analysis. J Popul Ther Clin Pharmacol 2013; 20: e171-e183
• 2 Böer B, Hoopmann M, Hübner M. et al.. Hyperemesis gravidarum. Geburtshilfe Frauenheilkd 2011; 71: 26-37 doi:10.1055/s-0030-1250769
• 3 Leeners B. Nausea, Emesis und Hyperemesis gravidarum. In: Rath W, Gembruch U, Schmidt S, Hrsg. Geburtshilfe und Perinatalmedizin. 2. Aufl.. Stuttgart: Thieme; 2010
• 4 Williamson C, Girling J. Hepatic and gastrointestinal disease. In: James DK, Steer PJ, Weiner CP, Gonik B, Crowther CA, Robson SC. eds. High Risk Pregnancy: Management Options. 4th ed. Philadelphia: Saunders Elsevier; 2016: 851
• 5 Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987; 150: 782-786
• 6 Commmittee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 189: Nausea And Vomiting Of Pregnancy. Obstet Gynecol 2018; 131: e15-e30 doi:10.1097/aog.0000000000002456
• 7 Royal College of Obstetricians and Gynecologists. The Management of Nausea and Vomiting of Pregnancy and hyperemesis Gravidarum (2016). Im Internet: https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg69/ Stand: 23.06.2018
• 8 Ebrahimi N, Maltepe C, Bournissen FG. et al.. Nausea and vomiting of pregnancy: using the 24-hour Pregnancy-Unique Quantification of Emesis (PUQE-24) scale. J Obstet Gynaecol Canada 2009; 31: 803-807 doi:10.1016/s1701-2163(16)34298-0
• 9 Koren G, Boskovic R, Hard M. et al.. Motherisk-PUQE (pregnancy-unique quantification of emesis and nausea) scoring system for nausea and vomiting of pregnancy. Am J Obstet Gynecol 2002; 186: S228-S231
• 10 Lacasse A, Rey E, Ferreira E. et al.. Validity of a modified Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) scoring index to assess severity of nausea and vomiting of pregnancy. Am J Obstet Gynecol 2008; 198: e71-e77 doi:10.1016/j.ajog.2007.05.051
• 11 Fiaschi L, Nelson-Piercy C, Gibson J. et al.. Adverse Maternal and Birth Outcomes in Women Admitted to Hospital for Hyperemesis Gravidarum: a Population-Based Cohort Study. Paediatric Perinat Epidemiol 2018; 32: 40-51 doi:10.1111/ppe.12416
• 12 Veenendaal MV, van Abeelen AF, Painter RC. et al.. Consequences of hyperemesis gravidarum for offspring: a systematic review and meta-analysis. BJOG 2011; 118: 1302-1313 doi:10.1111/j.1471-0528.2011.03023.x
• 13 Fejzo MS, Magtira A, Schoenberg FP. et al.. Neurodevelopmental delay in children exposed in utero to hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol 2015; 189: 79-84 doi:10.1016/j.ejogrb.2015.03.028
• 14 Maltepe C, Koren G. Preemptive treatment of nausea and vomiting of pregnancy: results of a randomized controlled trial. Obstet Gynecol Int 2013; 2013: 809787 doi:10.1155/2013/809787
• 15 Sharifzadeh F, Kashanian M, Koohpayehzadeh J. et al.. A comparison between the effects of ginger, pyridoxine (vitamin B6) and placebo for the treatment of the first trimester nausea and vomiting of pregnancy (NVP). J Matern Fetal Neonatal Med 2018; 31: 2509-2514 doi:10.1080/14767058.2017.1344965
• 16 Adlan AS, Chooi KY, Mat Adenan NA. Acupressure as adjuvant treatment for the inpatient management of nausea and vomiting in early pregnancy: A double-blind randomized controlled trial. J Obstet Gynaecol Res 2017; 43: 662-668 doi:10.1111/jog.13269
• 17 Carstairs SD. Ondansetron use in pregnancy and birth defects: A systematic review. Obstet Gynecol 2016; 127: 878-883 doi:10.1097/aog.0000000000001388
• 18 Carmichael SL, Shaw GM. Maternal corticosteroid use and risk of selected congenital anomalies. Am J Med Genetics 1999; 86: 242-244
• 19 Fejzo MS, Macgibbon KW, Romero R. et al.. Recurrence risk of hyperemesis gravidarum. J Midwifery Womens Health 2011; 56: 132-136 doi:10.1111/j.1542-2011.2010.00019.x