Implementing standardised rhodes index to measure the efficacy of ginger extract (Zingiber officinale) in pregnancy induced nausea and vomiting

Background: Although nausea and vomiting are natural signs of pregnancy affecting about half the pregnant women during their first trimester of pregnancy, it is unpleasant and difficult symptom to deal with. Considering the fact that medication during pregnancy is not advised, we decided to study the efficacy of a natural product to control nausea and vomiting during early pregnancy. Our study was directed to estimate the efficacy of ginger extract (Zingiber officinale) in pregnancy induced nausea and vomiting.Methods: A total of 30 women with pregnancy of 4-16 weeks, suffering from nausea and vomiting were included in this study (n=30). Subjects were given ginger extract 250mg, to be taken 3 times a day half an hour before food for 1 week. Severity of vomiting was assessed by Rhodes Index of Nausea and Vomiting by the patients. Baseline scores were compared with the score at the end of 7 day. The findings were analysed statistically.Results: Effect with the ginger extract in pregnancy induced nausea and vomiting was assessed at the end of treatment (day 7) and compared with the baseline values. Four patients reported symptoms of heartburn. Otherwise, there were no other reports of any adverse effects. The results showed significance (p <0.005).Conclusions: Ginger extract (Zingiber officinale) helps in reducing severity and frequency of pregnancy induced nausea and vomiting. Therefore, we conclude that ginger extract can be used for mild to moderate nausea and vomiting induced by pregnancy during first trimester.

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Effectiveness of Ginger in Treating Nausea and Vomiting of Pregnancy

Eureka Herba Indonesia ◽

10.37275/ehi.v3i1.46 ◽

2021 ◽

Vol 3 (1) ◽

pp. 120-124

Author(s):

Ahmad Ramadhanu

Keyword(s):

Lifestyle Modification ◽

First Trimester ◽

Nausea And Vomiting ◽

Main Complaint ◽

Significant Burden ◽

First Trimester Of Pregnancy ◽

Cns Side Effects ◽

Possible Cause ◽

In Pregnancy

Nausea and vomiting in pregnancy (NVP) is one of the common main complaint in pregnancy. NVP can be a significant burden to the patient, make a decrease in quality of life, pregnancy threatening or even worse can lead to nutritional loss and death. NVP diagnosed when in first trimester of pregnancy and the other possible cause of NVP is excluded. Management of NVP is included maintaining hydration, nutrition, and lifestyle modification. Also avoiding the smells, food, or activity that can cause nause are necessary. There are some methods to treat NVP including pharmalogical or non-pharmalogical. The non-pharmalogical approach is change nutritional habits, lifestyle and medications. Several pharmalogical agents that can be used to relief the symptoms of NVP are pyridoxine, anti- histamines, metoclopramide, pyridoxine/doxylamine, promethazine and metoclopramide. Some patients also want to try more “natural” medications for NVP like ginger. The pharmacological activity is thought to stand in the pungent principles (gingerols and shogaols) and volatile oils (sesquiterpenes and monoterpenes). The true mechanism of action of ginger is probable to be a gastric effect, to increase tone and peristaltic due to anticholinergic and antiserotonin act. Ginger acts straight to the digestive tract and avoids the CNS side effects common to centrally acting antiemetics. Ginger is available in capsule or syrup form or in candy, cookies, beer, tinctures, teas, sodas, and jam. Nowadays, true dosing is available only if one uses standardized extracts; however, women may choose to use another form of ginger.

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Efektifitas Pemberian Serbuk Jahe (Zingiber Officinale) Terhadap Tingkatan Mual Muntah Pada Ibu Hamil

Jurnal Ilmu Kesehatan ◽

10.32831/jik.v4i1.70 ◽

2017 ◽

Vol 4 (1) ◽

pp. 18

Author(s):

Finta Isti Kundarti ◽

Dwi Estuning Rahayu ◽

Reni Utami

Keyword(s):

Pregnant Women ◽

Health Workers ◽

Zingiber Officinale ◽

First Trimester ◽

Nausea And Vomiting ◽

Systematic Sampling ◽

P Value ◽

Effective Administration ◽

Ginger Powder ◽

First Trimester Of Pregnancy

Nausea and vomiting is a common disorder experienced by 50% of pregnant women in the first trimester of pregnancy. Efforts to reduce the symptoms can be with food or drinks containing ginger. Ginger has antiemetic and anxiolytic activity. The aim of this study was to determine the effectiveness of ginger to decrease nausea and vomiting in pregnant women 0-16 weeks gestation. The type of research design used is quasy Experimental design. The population in this study were all pregnant women 0-16 weeks gestation who experience nausea and vomiting as many as 24 people in the sub-district Puskesmas Wonorejo Ngadiluwih Kediri. The sample in this study 24 people with using cluster random sampling and systematic sampling. The instrument used was a questionnaire and rhodes INVR. Analysis of the results using Wilcoxon Match Pairs Test test results obtained p value 0.033 ;0.05 then H0 is rejected so that there are differences decrease nausea and vomiting in pregnant women 0-16 weeks gestation who were not given the ginger and ginger. In conclusion the effective administration of ginger powder to decrease nausea and vomiting in pregnant women aged 0-16 weeks. Suggested for health workers to use ginger as a treatment alternative for reducing nausea and vomiting inpregnant women.Keywords: Giving of ginger powder, decrease of nausea and vomiting, pregnant women

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DIAGNOSIS AND MANAGEMENT OF NAUSEA AND VOMITING IN PREGNANCY

Fetal and Maternal Medicine Review ◽

10.1017/s0965539505001701 ◽

2006 ◽

Vol 17 (1) ◽

pp. 45-67 ◽

Cited By ~ 3

Author(s):

LAURA MAGEE ◽

ALON SHRIM ◽

GIDEON KOREN

Keyword(s):

Weight Loss ◽

Hyperemesis Gravidarum ◽

Wide Spectrum ◽

First Trimester ◽

The Other ◽

Nausea And Vomiting ◽

Electrolyte Imbalance ◽

The Common ◽

Moderate Nausea ◽

In Pregnancy

Nausea and vomiting of pregnancy (NVP) is a term used to describe a wide spectrum of symptoms. At one end of the spectrum is the common, mild to moderate nausea and vomiting that is usually limited to the first trimester. At the other end of the spectrum are the intractable, severe symptoms of hyperemesis gravidarum (HG) that is associated with weight loss, dehydration, electrolyte imbalance and hospitalisation.

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Literature Review: The Effectiveness of Giving Ginger (Zingiber Officinale Roscoe) to Pregnant Women Nausea Vomiting 1st Trimester Pregnancy

Eduvest - Journal Of Universal Studies ◽

10.36418/edv.v1i8.147 ◽

2021 ◽

Vol 1 (8) ◽

pp. 803-809

Author(s):

Mahayu Ciptaning Mulia ◽

Catur Leny Wulandari

Keyword(s):

Pregnant Women ◽

Zingiber Officinale ◽

First Trimester ◽

Nausea And Vomiting ◽

Electrolyte Balance ◽

Literature Study ◽

Morning Sickness ◽

Trimester Pregnancy ◽

Zingiber Officinale Roscoe ◽

First Trimester Of Pregnancy

Nausea and vomiting often occur when you wake up in the morning, which is also called morning sickness. Nausea and vomiting that occur in the first trimester of pregnancy are caused by increased levels of the hormone Estrogen and Human Chorionic Gonadotropine (HCG) in serum from the placenta and can cause a decrease in appetite so that there is a change in electrolyte balance with potassium, calcium and sodium which causes changes in body metabolism. Nausea and vomiting during pregnancy affects about 80-90% of pregnant women. Ginger (Zingiber officinale Roscoe) is the most widely used herbal therapy in the management of nausea and vomiting. The purpose of this study was to determine how effectiveness ginger was in reducing the frequency of nuesea and vomiting in pregnant women in the 1st trimester.This study uses a literature study method obtained through electronic media with keywords. There were 8 selected articles, consisting of 5 international and 3 national articles. This article provides information about the effectiveness of giving ginger to reduce the frequency of nausea and vomiting in pregnant women in the 1st trimester. The conclusions obtained from the analysis are that ginger can reduce nausea and vomiting in pregnant women in the 1st trimester.

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Axial torsion of Meckel’s diverticulum causing acute peritonitis in the first trimester of pregnancy: a case report

Surgical Case Reports ◽

10.1186/s40792-019-0754-y ◽

2019 ◽

Vol 5 (1) ◽

Author(s):

Hiromitsu Nagata ◽

Hiroyasu Nishizawa ◽

Susumu Mashima ◽

Yasuyuki Shimahara

Keyword(s):

Clinical Diagnosis ◽

Meckel’S Diverticulum ◽

Ileocecal Valve ◽

First Trimester ◽

Meckel's Diverticulum ◽

Ileocecal Resection ◽

Bowel Loop ◽

Axial Torsion ◽

First Trimester Of Pregnancy ◽

In Pregnancy

Abstract Background Meckel’s diverticulum is considered the most prevalent congenital anomaly of the gastrointestinal tract. Approximately 4% of patients are symptomatic with complications such as bleeding, intestinal obstruction, and inflammation, while axial torsion of Meckel’s diverticulum is rare, particularly in pregnancy. Case presentation A 31-year-old woman in week 15 of pregnancy complained of epigastric pain, nausea and vomiting. Clinical diagnosis was severe hyperemesis gravidarum. Because the symptoms persisted during hospitalization, CT was performed and revealed dilated small bowel loops with multiple air-fluid levels. In the right mid-abdomen, there was a large part of air containing a cavity connected to the small intestine, which was considered a dilated bowel loop. Emergency laparotomy was performed and axial torsion of a large Meckel’s diverticulum measuring 11 cm was found at a few centimeters proximal to the ileocecal valve. Ileocecal resection including Meckel’s diverticulum was performed. The postoperative course was uneventful. At 40 weeks gestation, she had vaginal delivery of normal baby. Conclusion The physiological and anatomical changes in pregnancy can make a straightforward clinical diagnosis difficult. Prompt diagnosis and management were needed in order to avoid significant maternal and fetal risks. The use of imaging examinations, especially CT examination, with proper timing may be helpful to prevent delay in diagnosis and surgical intervention. Here, we report the case of a patient with axial torsion of Meckel’s diverticulum in pregnancy. To our knowledge, axial torsion of Meckel’s diverticulum in the first trimester of pregnancy has not been reported in the English medical literature.

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AYURVEDIC MANAGEMENT OF GARBHINI CHARDI (Emesis Gravidarum) WITH CHATURJATA CHOORNA (CHATURJATA POWDER) - A PILOT STUDY

November 2020 - International Ayurvedic Medical Journal ◽

10.46607/iamj0308072020 ◽

2020 ◽

Vol 8 (9) ◽

pp. 4317-4323

Author(s):

Priyanka 1 ◽

Shreyes. S ◽

Yogitha Bali M.R

Keyword(s):

Pilot Study ◽

Pregnant Women ◽

First Trimester ◽

Nausea And Vomiting ◽

Morning Sickness ◽

Excessive Salivation ◽

First Trimester Of Pregnancy ◽

Rice Water ◽

Single Blind

Background: During pregnancy many demands are made by growing fetus, to meet these requirements maternal system has to undergo certain changes. Garbhinichardi (Emesis Gravidarum) is one among them and this has been termed as Gruhita Garbha Lakshanas (Immediate signs of conception) in Ayurvedic clas-sics. Approximately 80 % of pregnant women experience excessive salivation, nausea and vomiting during pregnancy, commonly known as “morning sickness”, which is seen frequently throughout the day. Design: This is single blind pilot study. 30 patients with complaints of Garbhinichardi (Emesis Gravidarum) in first trimester were included in this study. Patients were given Chaturjatachurna (Chatutjata powder)for a peri-od of 2 weeks in dose of 3gms thrice a day after meal with Anupana (Adjuvant) as Madhu (honey) of 5ml mixed with Tandulodaka (Raw rice water) Results: This pilot study showed statistically significant changes with Chaturjatachurna in reducing the complaints of pregnant women such as nausea (p<0.001), vomiting (p<0.001) and Aruchi (Anorexia) (p<0.001) in their first trimester of pregnancy. Conclusion: Chaturjata-churna was effective in the management of Garbhini Chardi (Emesis Gravidarum) and other symptoms in the first trimester of pregnancy.

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Pregnancy Sickness

Physiology ◽

10.1152/physiologyonline.1990.5.1.5 ◽

1990 ◽

Vol 5 (1) ◽

pp. 5-10 ◽

Cited By ~ 3

Author(s):

P Andrews ◽

S Whitehead

Keyword(s):

Early Pregnancy ◽

First Trimester ◽

Nausea And Vomiting ◽

Current Understanding ◽

Physiological Changes ◽

Inappropriate Response ◽

First Trimester Of Pregnancy

The majority of women suffer from nausea and vomiting in the first trimester of pregnancy, but the mechanisms and reasons for this are unknown. Based on our current understanding of the emetic response and physiological changes of early pregnancy, hypotheses are put forward to explain this apparently inappropriate response to conception.

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Suicide due to fear of COVID-19, in pregnancy, lead to Neonatal malformations: A case report

10.22541/au.162373187.73918053/v1 ◽

2021 ◽

Author(s):

Javad Boskabadi ◽

Saeed Kargar-Soleiman abad ◽

shahrokh mehrpishe ◽

Elham Pishavar ◽

Roya Farhadi

Keyword(s):

Mental Health ◽

Case Report ◽

Antipsychotic Drugs ◽

First Trimester ◽

Limited Data ◽

First Trimester Of Pregnancy ◽

In Pregnancy

There is limited data about various effect of COVID-19 in pregnancy. The Covid-19 pandemic can increase anxiety or schizophrenia exacerbation. Neonatal malformations from antipsychotic drugs exposures during first trimester of pregnancy have been reported. However, their effect near delivery have been less studied. Keywords: Covid-19, pregnancy, mental health, neonatal malformations

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Myasthenia Gravis in Pregnancy Treated With Daily Massive Vitamin D Dose

Asploro Journal of Biomedical and Clinical Case Reports ◽

10.36502/2020/asjbccr.6208 ◽

2020 ◽

Vol 3 (2) ◽

pp. 171-177

Author(s):

Silva LFF ◽

Martins MC ◽

Caplum MC ◽

Luz MS ◽

Amaral VM ◽

...

Keyword(s):

Vitamin D ◽

T Cells ◽

Myasthenia Gravis ◽

Striated Muscle ◽

First Trimester ◽

Effector T Cells ◽

Myasthenic Crisis ◽

First Trimester Of Pregnancy ◽

Muscle Groups ◽

In Pregnancy

Myasthenia gravis (MG) is an autoimmune disease affecting the motor endplate of striated muscle. It is caused by antibodies that act in the cholinergic receptors at the post-synaptic portion of the neuromuscular junction, which results in asthenia and fatigue in some muscle groups. In pregnancy, it’s unpredictable, because pregnant women can present MG exacerbation, remission, stability, or even a myasthenic crisis during pregnancy. Complications are more frequent in the first trimester of pregnancy and the first 30 days of puerperium. Vitamin D and its metabolites are potent immunomodulators since their immuno-regulatory effect directly inhibits effector T cells and induces regulatory T cells (Treg) to decrease the production of inflammatory cytokines. The authors present a case report of a patient with MG who was treated throughout pregnancy with massive doses of vitamin D, obtaining good results.

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Gestational Thyrotoxicosis in a Patient With Hyperemesis Gravidarum

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.1898 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A929-A929

Author(s):

Hind Alameddine ◽

Gurunanthan Palani ◽

Kidmealem Zekarias

Keyword(s):

Hyperemesis Gravidarum ◽

Clinical Signs ◽

Supportive Therapy ◽

First Trimester ◽

Nausea And Vomiting ◽

Antithyroid Drugs ◽

Significant Elevation ◽

Free T4 ◽

Overt Hyperthyroidism ◽

In Pregnancy

Abstract Untreated or inadequately treated overt hyperthyroidism in pregnancy can have devastating consequences for both mother and fetus. At the same time antithyroid drugs (ATDs) are known for their teratogenic effect and should be avoid when possible; once the diagnosis of hyperthyroidism is made in a pregnant woman, attention should be focused on determining the etiology of the disorder and whether it warrants treatment. Here, we report a case of hyperemesis gravidarum patient presenting with significant elevation of thyroid hormones and a review on diagnosis and management of gestational transient thyrotoxicosis. A 33-year-old female, G4P3 at 8 weeks pregnant admitted for nausea and vomiting. Thyroid labs showed TSH < 0.01 (Reference: 0.4-4.0mU/L) and free T4 is 3.53 (Reference: 0.76-1.46ng/dl). Patient was discharged on antiemetics with a diagnosis of hyperemesis gravidarum. She was re-admitted at 9 weeks pregnant with ongoing nausea and vomiting. She had palpitations, fatigue and reported 15 pound weight loss in 2 weeks. Past medical history included thyroid hormone abnormality noted during pregnancies of 2011 and 2017. Physical exam was significant for tachycardia and diffusely enlarged thyroid gland. Repeat labs showed TSH <0.01, free T4 5.81, total T3 of 317 (Reference: 60-181ng/dl). Thyroid ultrasound showed multiple nodules. Considering significant elevation in free T4 and total T3; empiric therapy with propylthiouracil was recommended. Patient declined anti-thyroid therapy. TSI and TRH antibodies came back later as negative. Patient was treated with enteral feeding for hyperemesis gravidarum. Thyroid labs 3 weeks later improved; FT4 down to 1.63 and TT3 down to 250. Patient delivered healthy baby at 40 weeks of gestation. Although the differential diagnosis of thyrotoxicosis in pregnancy includes any cause that can be seen in a nonpregnant patient, the most likely causes for hyperthyroidism in pregnancy are gestational thyrotoxicosis (GTT) with or without hyperemesis gravidarum or Graves’ disease. GTT is described as an hCG-mediated hyperthyroidism that occurs in the first trimester of pregnancy; it is generally asymptomatic with mild biochemical hyperthyroidism. Distinguishing true overt hyperthyroidism from GTT in a setting of hyperemesis gravidarum is challenging. The absence of clinical signs of hyperthyroidism and negative thyroid antibodies supports the diagnosis of GTT. T3 tends to be disproportionately elevated more than T4 in patients with overt hyperthyroidism. HCG level has not been found to be useful in distinguishing between GTT and GD. Overt hyperthyroidism is treated using anti-thyroid drugs (ATD) whereas supportive therapy without ATD is the accepted standard of treatment of patients with hyperemesis gravidarum and GTT. More studies addressing the best management of these group of patients is needed.

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