scholarly journals The Leading Concerns of American Women with Nausea and Vomiting of Pregnancy Calling Motherisk NVP Helpline

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Svetlana Madjunkova ◽  
Caroline Maltepe ◽  
Gideon Koren
Keyword(s):  
Drug Safety ◽  
Vitamin B6 ◽  
Hyperemesis Gravidarum ◽  
Medical Condition ◽  
Demographic Data ◽  
Nausea And Vomiting ◽  
Severe Condition ◽  
American Women ◽  
Common Medical Condition ◽  
The Usa

Background. Nausea and vomiting of pregnancy (NVP) is the most common medical condition of pregnancy, affecting up to 85% of expecting mothers. In the USA, there is no FDA-approved medication for the treatment of NVP.Objective. To identify the primary concerns of American women leading them to contact the Motherisk NVP Helpline and to characterize the severity of their symptoms and therapy offered in order to develop improved and customized counseling for them.Methods. We reviewed the intake forms of the American women who called the NVP Helpline from 2008 to 2012. We extracted their state of residence, demographic data, severity of NVP symptoms, and other available clinical characteristics.Results. A total of 195 forms were reviewed. Of these, 86% called for information on management of NVP with/without questions about fetal drug safety, while 14% called solely about drug safety during pregnancy/breastfeeding. The majority of women were Caucasian, in their thirties, educated, employed, married and in their second pregnancy. Of them 95% were suffering from moderate-to-severe condition with 13% having hyperemesis gravidarum.Conclusion. American women need more information on the management of NVP and on a variety of its aspects in addition to the safety and effectiveness of antiemetic medications. Their leading concern was the use of doxylamine and vitamin B6 combination for NVP treatment followed by the use of ondansetron.

scholarly journals Surgical Options for Apical Prolapse Repair

2012 ◽  
Vol 8 (5) ◽  
pp. 557-566
Author(s):  
Ngoc-Bich Le ◽  
Lisa Rogo-Gupta ◽  
Shlomo Raz
Keyword(s):  
Pelvic Organ Prolapse ◽  
Primary Care Physicians ◽  
Medical Condition ◽  
Pelvic Organ ◽  
Medical Community ◽  
Apical Prolapse ◽  
Prolapse Repair ◽  
Common Medical Condition ◽  
The Usa ◽  
Surgical Options

Pelvic organ prolapse is a common medical condition that affects the quality of life of many women. Approximately 50% of parous women have pelvic organ prolapse and the lifetime risk for surgical intervention is 6.7% at the age of 80 years. In the USA, the number of women at risk for symptomatic prolapse is increasing, which is consistent with the recent increase in the overall number of prolapse and incontinence procedures being performed. Although prolapse is usually multicompartmental and isolated defects are rare, the apical compartment deserves special attention because apical support is integral to a durable prolapse repair. Since many women may initially present to their primary care physicians, all members of the medical community should have a basic understanding of the diagnosis and treatment for apical prolapse.

Association of transient hyperthyroidism and severity of hyperemesis gravidarum

2017 ◽  
Vol 30 (3) ◽  
Author(s):  
Nor Zila Hassan Malek ◽  
Aida Kalok ◽  
Zainal Abidin Hanafiah ◽  
Shamsul Azhar Shah ◽  
Nor Azlin Mohamed Ismail
Keyword(s):  
Thyroid Function ◽  
Early Pregnancy ◽  
Hyperemesis Gravidarum ◽  
Demographic Data ◽  
Thyroid Autoimmunity ◽  
Clinical Signs ◽  
Nausea And Vomiting ◽  
Full Blood Count ◽  
Free T4 ◽  
In Pregnancy

AbstractBackgroundTransient non-immune hyperthyroidism in early pregnancy is hyperthyroidism diagnosed for the first time in early pregnancy, without evidence of thyroid autoimmunity or clinical findings of Grave’s disease and resolved spontaneously as the pregnancy progressed. Hyperemesis gravidarum (HG) is the commonest cause with 66%–73% of women with severe HG were found to have elevated thyroid function.Materials and methodsWe conducted a cross sectional study to determine the prevalence of transient hyperthyroidism in patients with hyperemesis gravidarum and its relation to the severity of nausea and vomiting. Severity of nausea and vomiting in pregnancy was assessed using the modified pregnancy-unique quantification of emesis (PUQE) scoring system. Each patient had urine and blood investigations which also included a full blood count and thyroid and renal function tests. Patients with abnormal thyroid function were retested at 20 weeks of gestation. The patients’ demographic data, electrolyte levels, thyroid function and their respective PUQE score were analyzed.ResultsThe prevalence of transient hyperthyroidism in women with hyperemesis gravidarum was 4.8%. Although there was a significant association between the severity of the PUQE score and hypokalemia (p = 0.001), there was no significant association with transient hyperthyroidism in early pregnancy (p = 0.072). Free T4 and TSH values of all women with transient hyperthyroidism were normalized by 20 weeks of gestation.ConclusionTransient hyperthyroidism in pregnancy is not significantly associated with the severity of the PUQE score. Women with transient hyperthyroidism in pregnancy are normally clinically euthyroid, hence a routine thyroid function test is unnecessary unless they exhibit clinical signs or symptoms of hyperthyroidism.

scholarly journals Treatments for hyperemesis gravidarum and nausea and vomiting in pregnancy: a systematic review and economic assessment

2016 ◽  
Vol 20 (74) ◽  
pp. 1-268 ◽  
Author(s):  
Amy O’Donnell ◽  
Catherine McParlin ◽  
Stephen C Robson ◽  
Fiona Beyer ◽  
Eoin Moloney ◽  
...  
Keyword(s):  
Systematic Review ◽  
Economic Evaluation ◽  
High Risk ◽  
Vitamin B6 ◽  
Citation Index ◽  
Hyperemesis Gravidarum ◽  
Nausea And Vomiting ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
In Pregnancy

BackgroundNausea and vomiting in pregnancy (NVP) affects up to 85% of all women during pregnancy, but for the majority self-management suffices. For the remainder, symptoms are more severe and the most severe form of NVP – hyperemesis gravidarum (HG) – affects 0.3–1.0% of pregnant women. There is no widely accepted point at which NVP becomes HG.ObjectivesThis study aimed to determine the relative clinical effectiveness and cost-effectiveness of treatments for NVP and HG.Data sourcesMEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, PsycINFO, Commonwealth Agricultural Bureaux (CAB) Abstracts, Latin American and Caribbean Health Sciences Literature, Allied and Complementary Medicine Database, British Nursing Index, Science Citation Index, Social Sciences Citation Index, Scopus, Conference Proceedings Index, NHS Economic Evaluation Database, Health Economic Evaluations Database, China National Knowledge Infrastructure, Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects were searched from inception to September 2014. References from studies and literature reviews identified were also examined.Obstetric Medicinewas hand-searched, as were websites of relevant organisations. Costs came from NHS sources.Review methodsA systematic review of randomised and non-randomised controlled trials (RCTs) for effectiveness, and population-based case series for adverse events and fetal outcomes. Treatments: vitamins B6 and B12, ginger, acupressure/acupuncture, hypnotherapy, antiemetics, dopamine antagonists, 5-hydroxytryptamine receptor antagonists, intravenous (i.v.) fluids, corticosteroids, enteral and parenteral feeding or other novel treatment. Two reviewers extracted data and quality assessed studies. Results were narratively synthesised; planned meta-analysis was not possible due to heterogeneity and incomplete reporting. A simple economic evaluation considered the implied values of treatments.ResultsSeventy-three studies (75 reports) met the inclusion criteria. For RCTs, 33 and 11 studies had a low and high risk of bias respectively. For the remainder (n = 20) it was unclear. The non-randomised studies (n = 9) were low quality. There were 33 separate comparators. The most common were acupressure versus placebo (n = 12); steroid versus usual treatment (n = 7); ginger versus placebo (n = 6); ginger versus vitamin B6 (n = 6); and vitamin B6 versus placebo (n = 4). There was evidence that ginger, antihistamines, metoclopramide (mild disease) and vitamin B6 (mild to severe disease) are better than placebo. Diclectin®[Duchesnay Inc.; doxylamine succinate (10 mg) plus pyridoxine hydrochloride (10 mg) slow release tablet] is more effective than placebo and ondansetron is more effective at reducing nausea than pyridoxine plus doxylamine. Diclectin before symptoms of NVP begin for women at high risk of severe NVP recurrence reduces risk of moderate/severe NVP compared with taking Diclectin once symptoms begin. Promethazine is as, and ondansetron is more, effective than metoclopramide for severe NVP/HG. I.v. fluids help correct dehydration and improve symptoms. Dextrose saline may be more effective at reducing nausea than normal saline. Transdermal clonidine patches may be effective for severe HG. Enteral feeding is effective but extreme method treatment for very severe symptoms. Day case management for moderate/severe symptoms is feasible, acceptable and as effective as inpatient care. For all other interventions and comparisons, evidence is unclear. The economic analysis was limited by lack of effectiveness data, but comparison of costs between treatments highlights the implications of different choices.LimitationsThe main limitations were the quantity and quality of the data available.ConclusionThere was evidence of some improvement in symptoms for some treatments, but these data may not be transferable across disease severities. Methodologically sound and larger trials of the main therapies considered within the UK NHS are needed.Study registrationThis study is registered as PROSPERO CRD42013006642.FundingThe National Institute for Health Research Health Technology Assessment programme.

HIPEREMESIS GRAVIDARUM PADA IBU HAMIL DI KLINIK BIDAN SUPRIYATI SRIBIT BERBAH SLEMAN

2019 ◽  
Vol 14 (1) ◽  
pp. 51
Author(s):  
Pramukti Dian Setianingrum ◽  
Farah Irmania Tsani
Keyword(s):  
Blood Pressure ◽  
Pregnant Women ◽  
Hyperemesis Gravidarum ◽  
Unwanted Pregnancy ◽  
The Body ◽  
Nausea And Vomiting ◽  
Daily Activities ◽  
World Health ◽  
The World

Backgroud: The World Health Organization (WHO) explained that the number of Hyperemesis Gravidarum cases reached 12.5% of the total number of pregnancies in the world and the results of the Demographic Survey conducted in 2007, stated that 26% of women with live births experienced complications. The results of the observations conducted at the Midwife Supriyati Clinic found that pregnant women with hyperemesis gravidarum, with a comparison of 10 pregnant women who examined their contents there were about 4 pregnant women who complained of excessive nausea and vomiting. Objective: to determine the hyperemesis Gravidarum of pregnant mother in clinic. Methods: This study used Qualitative research methods by using a case study approach (Case Study.) Result: The description of excessive nausea of vomiting in women with Hipermemsis Gravidarum is continuous nausea and vomiting more than 10 times in one day, no appetite or vomiting when fed, the body feels weak, blood pressure decreases until the body weight decreases and interferes with daily activities days The factors that influence the occurrence of Hyperemesis Gravidarum are Hormonal, Diet, Unwanted Pregnancy, and psychology, primigravida does not affect the occurrence of Hyperemesis Gravidarum. Conclusion: Mothers who experience Hyperemesis Gravidarum feel nausea vomiting continuously more than 10 times in one day, no appetite or vomiting when fed, the body feels weak, blood pressure decreases until the weight decreases and interferes with daily activities, it is because there are several factors, namely, hormonal actors, diet, unwanted pregnancy, and psychology.

Comparison of the effects of Dexamethasone and Ondansetron on the Reduction of Postoperative Nausea and Vomiting following Cesarean Section under Spinal Anesthesia

2020 ◽  
Vol 15 ◽  
Author(s):  
Arash karimi ◽  
Jahanbakhsh Nejadi ◽  
Mahnaz Shamseh ◽  
Nooshin Ronasi ◽  
Mehdi Birjandi
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Postoperative Nausea ◽  
Demographic Data ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Elective Cesarean Section ◽  
Double Blind ◽  
Group A ◽  
Group B

Background: Postoperative nausea and vomiting (PONV) is a common complication associated with the use of anesthesia. Several antiemetics are used to reduce the incidence and severity of PONV. The aim of this study is to investigate the role of dexamethasone and ondansetron to treat PONV in patients undergoing cesarean section (c-section) under spinal anesthesia. Methods: This double-blind clinical trial study was performed on patients who were referred to the operating room of Haji Karim Asali Hospital of Khorramabad for elective cesarean section in 2016-17. Upon meeting the inclusion criteria, patients were allotted into two groups (n=60). Group A received 8mg of dexamethasone and group B received 4mg of ondansetron after spinal anesthesia. The Visual Analog Scale (VAS) questionnaire and Depression-Anxiety-Stress Scale (DASS) questionnaire was used for the analysis. Patients with mild to moderate stress, anxiety, and depression were included in the study. Data were analyzed using SPSS 16 software. Results: There was no difference in the demographic data of the two groups. The mean severity of nausea in group A was significantly higher than in group B. The frequency of vomiting in group A was 20 times higher than group B, which was found to be statistically significant, p = 0.018. Concerning the type of delivery with the frequency of nausea, the results showed that the frequency of nausea in group A was 3.24 times higher than group B, however, this difference was not statistically significant, p = 0.106. Conclusion: Based on the results of this study, ondansetron had a significant effect on the alleviation of postoperative nausea and vomiting, as compared to dexamethasone in c-section surgical candidates.

scholarly journals Is the public supportive and willing to pay for a national assistive reproductive therapies programme? Results from a multicountry survey

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044986
Author(s):  
Chris Skedgel ◽  
Eleanor Ralphs ◽  
Elaine Finn ◽  
Jennifer A Whitty ◽  
Marie Markert ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Online Survey ◽  
Medical Condition ◽  
Public Attitudes ◽  
Fertility Treatment ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Additional Contribution ◽  
The Public ◽  
The Usa

ObjectivesTo understand attitudes towards infertility and willingness to pay (WTP) towards a publicly funded national assistive reproductive therapies (ART) programme.DesignAttitudes survey with dichotomous and open-ended WTP questions.SettingOnline survey administered in the USA, UK, Spain, Norway, Sweden, Finland, Denmark and China.Participants7945 respondents, analysed by country. Nordic respondents were pooled into a regionally representative sample.Primary and secondary outcome measuresPrimary outcome measures were proportion of sample agreeing with different infertility-related and ART-related value statements and supporting a monthly contribution to fund a national ART programme, expressed in local currency. Secondary outcome measure was maximum WTP.ResultsAcross the nationally representative samples, 75.5% of all respondents agreed with infertility as a medical condition and 82.3% and 83.7% with ART eligibility for anyone who has difficulty having a baby or a medical problem preventing them from having a baby, respectively. 56.4% of respondents supported a defined monthly contribution and 73.9% supported at least some additional contribution to fund a national ART programme. Overall, converting to euros, median maximum WTP was €3.00 and mean was €15.47 (95% CI 14.23 to 16.72) per month. Maximum WTP was highest in China and the USA and lowest in the European samples.ConclusionsThis large, multicountry survey extends our understanding of public attitudes towards infertility and fertility treatment beyond Europe. It finds evidence that a majority of the public in all sampled countries/regions views infertility as a treatable medical condition and supports the idea that all infertile individuals should have access to treatments that improve the chance of conception. There was also strong agreement with the idea that the desire for children is a basic human need. WTP questions showed that a majority of respondents supported a monthly contribution to fund a national ART programme, although there is some evidence of an acquiescence bias that may overstate support among specific samples.

scholarly journals Coadministration of tizanidine and ciprofloxacin: a retrospective analysis of the WHO pharmacovigilance database

2021 ◽  
Author(s):  
Annette Rudolph ◽  
Hendrike Dahmke ◽  
Hugo Kupferschmidt ◽  
Andrea Burden ◽  
Stefan Weiler
Keyword(s):  
Real World ◽  
Safety Issue ◽  
Demographic Data ◽  
Fatal Outcome ◽  
Individual Case ◽  
World Health ◽  
Global Database ◽  
The Usa ◽  
Pharmacovigilance Database ◽  
The Impact

Abstract Purpose Tizanidine, an alpha-adrenergic substance with antinociceptive and antihypertensive effects, is extensively metabolized via cytochrome P450 (CYP) 1A2. Therefore, coadministration with potent CYP1A2 inhibitors, such as ciprofloxacin, is contraindicated. However, both drugs are broadly utilized in various countries. Their concomitant use bears an inherent high risk for clinically significant symptoms, especially in multimorbid patients experiencing polypharmacy. This study aims to investigate the impact of coadministration of tizanidine and ciprofloxacin using real-world pharmacovigilance data and to raise awareness of this potentially underestimated safety issue. Methods We conducted a retrospective study including Individual Case Safety Reports (ICSR) registered until March 1, 2017, in the World Health Organization (WHO) global database. Demographic data, drug administration information, the course of the adverse drug reaction (ADR), its severity, and outcomes were analyzed for cases reporting ciprofloxacin comedication. Results In 91 (2.0%) of the identified 4192 worldwide ICSR on tizanidine, coadministration of ciprofloxacin was reported. Most of the patients were female (n = 59, 64.8%) with a median age of 54 years (range 13–85 years). The countries contributing most reports were the USA (n = 54, 59.3%) and Switzerland (n = 16, 17.6%). ADRs reported most often affected the nervous system and the cardiac function, especially with large tizanidine doses or drugs with CNS and cardiovascular depressant effects. In two cases, a fatal outcome was reported. Conclusion Despite the existing formal contraindication, the concomitant use of tizanidine and ciprofloxacin can be observed in real-world clinical practice. Reactions mainly affected the central nervous and the cardiovascular system resulting in potentially severe adverse effects. The concomitant use of tizanidine and ciprofloxacin should absolutely be avoided.

scholarly journals EFEKTIFITAS PEMBERIAN PERMEN JAHE TERHADAP MUAL MUNTAH PADA IBU HAMIL DI KLINIK KHAIRUNIDA SUNGGAL TAHUN 2018

2019 ◽  
Vol 1 (1) ◽  
pp. 36-44
Author(s):  
Ani Nurdiana ◽  
Betty Mangkuji ◽  
Rismahara Lubis
Keyword(s):  
Pregnant Women ◽  
Hyperemesis Gravidarum ◽  
Sampling Technique ◽  
First Trimester ◽  
Statistical Test ◽  
Nausea And Vomiting ◽  
P Value ◽  
Nutritional Disorder ◽  
Average Decrease ◽  
Pharmacy Department

Pregnancy causes a lot of change in the mother’s body, so there are various kinds of physiological discomfort in the mother such as nause and vomiting, usually mild and controlable. This condition sometimes stops in the first trimester, but its effect may lead to nutritional disorder, dehydration, weakness, weight loss, and electrolyte imbalances. If not treated, it will worsen into Hyperemesis Gravidarum This study aimed to determine the effectiveness og ginger candy in reducing the frecuency of nause and vomiting in first trimester pregnant women in the Khairunida clinik with experimental Quasy design and tested by One Group Pretest Postest. About 15 samples were obtained through purposive sampling technique and the data were taken using the T-dependent test. Through the study, it was found that the frequency of nausea and vomiting before being given intervation was 10,93 and after being given intervation was 3,33 with an average decrease by 7,60. Through the statistical test, it was obtained the p value <(0.05) so that this study concluded that administration of ginger candy was effective in reduring nausea and vomiting in first trimester pregnant women. Further researchers are expected toreduce the use of non-pharmacological drugs to overcome nausea and vomiting in first trimester pregnant women and collaborate with the pharmacy department to facilitate the process of making good qualityy ginger candy.

scholarly journals Effect of ginger tea on chemotherapy-induced nausea and vomiting among cancer patients in selected hospitals, Bhubaneswar, Odisha

2020 ◽  
Vol 11 (1) ◽  
pp. 1165-1171
Author(s):  
Sasmita Das ◽  
Mary Preety Banra ◽  
Neethu Maria Joseph
Keyword(s):  
Cancer Patients ◽  
Research Design ◽  
Demographic Data ◽  
Large Population ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Food Component ◽  
Significant Difference ◽  
Chi Square Analysis ◽  
And Control

A quasi-experimental research study (posttest only research design) was conducted to evaluate the effect of ginger tea on chemotherapy-induced nausea and vomiting among cancer patients in selected hospitals of Bhubaneswar and to find out the association of level of chemotherapy-induced nausea and vomiting with selected socio-demographic variables. For this study, a quantitative experimental approach and post-test only research design was adopted. 100 patients were selected by convenience sampling technique and categorized into experimental (n=50) and control group (n=50) for this study. Self- structured socio-demographic proforma and self- structured record analysis proforma was used to collect socio-demographic data and modified nausea and vomiting scale was used to measure the level of chemotherapy-induced nausea and vomiting among cancer patients. The data was analyzed by using SPSS version 20.0 (Statistical Package for the Social Science). The post-testt level of chemotherapy-induced nausea and vomiting among experimental and control groups was compared by unpaired‘t’ test and the result showed (p=<0.0001) significant difference between both groups. The chi-square analysis shows a statistically significance association between chemotherapy-induced nausea and vomiting and the emetogenic potential of the drug in both groups and in control group age was also significance associated. The ANOVA test revealed the statistically significance of the posttest level of chemotherapy-induced nausea and vomiting within groups of the emetogenic potential of a drug. The present study concluded that the food component, like ginger tea, is an effective home remedy for the reduction of chemotherapy-induced nausea and vomiting among cancer patients. Further study can be conducted with a large population, different dose and compositions of ginger and with different adjuvant therapy to manage nausea and vomiting among cancer patients.

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