scholarly journals Hyperemesis gravidarum as a psychosomatic disorder: Case report

2003 ◽  
Vol 56 (3-4) ◽  
pp. 183-186 ◽  
Author(s):  
Artur Bjelica ◽  
Davorka Zoric ◽  
Aleksandra Kapamadzija ◽  
Milana Maticki-Sekulic
Keyword(s):  
Case Report ◽  
Hyperemesis Gravidarum ◽  
First Trimester ◽  
Psychological Status ◽  
Psychosomatic Disorder ◽  
Severe Vomiting ◽  
Gynecology And Obstetrics ◽  
Current Psychological ◽  
Novi Sad ◽  
In Pregnancy

Introduction Persistent severe vomiting in pregnancy is called hyperemesis gravidarum. The etiology of this disorder is still unknown. However, endocrinological disorders and psychological factors are mentioned as possible causes. Vomiting usually stops after the end of the first trimester of pregnancy. Case report A case of persistent, severe vomiting during pregnancy is reported. The patient was admitted to the Department of Gynecology and Obstetrics in Novi Sad in the 29th week gestation due to persistent vomiting from the beginning of pregnancy. A psychological evaluation including current psychological status was performed. The obtained results showed that hyperemesis gravidarum was a consequence of associated psychosocial factors, and conflicts causing somatic disorders. Conclusion Such cases point to the importance of psychotherapy in pregnancy either with or without drug therapy. In addition, we underline the importance of psychological preparation before pregnancy and better information about pregnancy and motherhood.

scholarly journals Olfactory perception in women with physiologically altered hormonal status (during pregnancy and postmenopause)

2002 ◽  
Vol 55 (9-10) ◽  
pp. 380-383 ◽  
Author(s):  
Slobodan Savovic ◽  
Dejan Nincic ◽  
Slobodanka Lemajic ◽  
Vladimir Pilija ◽  
Aljosa Mandic ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Endocrine System ◽  
Premenopausal Women ◽  
First Trimester ◽  
Olfactory Function ◽  
Hormonal Status ◽  
Emotional States ◽  
Olfactory Ability ◽  
Novi Sad ◽  
In Pregnancy

Introduction Olfaction is considered to be the ability to: perceive, conduct and recognize scents and odors. With its numerous connections to the limbic system and reticular formation, the olfactory system affects regulation of numerous vegetative functions, visceral functions and sexual behavior. Since estrogen and progesterone protect the olfactory function, changes in their levels in particular physiological states in women (in pregnancy and postmenopause) exert an influence on the ability to feel and recognize smells. It has its role in creating emotions and adjustment of visceral and vegetative response to particular emotional states. Also, it represents the connection between higher cortical functions and the endocrine system. Material and methods Our investigation was performed at the Ear, Nose and Throat Clinic in Novi Sad. The research included 80 healthy women classified into 4 groups; 20 women aged between 20 and 30; 20 women in the first trimester of pregnancy aged between 20 and 30; 20 premenopausal women aged between 41 and 50; and 20 women at least 3 years in postmenopause, aged between 41 and 50. For our research we used an olfactometer and the Fortunato-Niccolini method. Results and discussion In pregnancy the thresholds of perception (TP) and identification (TI) of examined substances were slightly lower in comparison to nonpregnant women of the same ages, but without any statistical significance (p>0.05). In climacteric-postmenopausal women there was a significant decrease of olfactory ability in comparison to nonmenopausal women of the same ages (p<0.01). Conclusion All changes of the olfactory function in pregnancy are explained by mental changes of pregnant women as well as their hormonal status. Significant decrease of olfactory ability in postmenopause is explained by decline in sexual hormone levels.

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

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

scholarly journals Gestational Thyrotoxicosis in a Patient With Hyperemesis Gravidarum

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 &lt; 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 &lt;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.

scholarly journals EFEKTIVITAS PEMBERIAN PISANG AMBON DAN VITAMIN B UNTUK MENURUNKAN HIPEREMESIS GRAVIDARUM DI BPM ENDAH BEKTI

2018 ◽  
Vol 7 (1) ◽  
pp. 17-21
Author(s):  
Elvika Fit Ari Shanti ◽  
Liberty Barokah ◽  
Budi Rahayu
Keyword(s):  
Pregnant Women ◽  
Vitamin B6 ◽  
Hyperemesis Gravidarum ◽  
Post Partum ◽  
Endocrine System ◽  
First Trimester ◽  
The Other ◽  
Vitamin B ◽  
Difference Test ◽  
In Pregnancy

Background: Endocrine system changes during pregnancy are important to keep the pregnancy, fetal growth and post partum recovery. Around 50-90% of pregnant women experience vomit and nausea. To solve those problems, ‘pisang ambon’ (Musa paradisiacal) consumption is one of choices because of its flavonoid and vitamin B6 which can overcome vomit and nausea in pregnancy. Objective: The aim of this research was to identify the effectiveness between pisang ambon (Musa paradisiacal) consumption and vitamin B6 to reduce hyperemesis gravidarum in BPM Endah Bekti. Methods: A quasy experimental design with two-group posttest only was assigned to 20 pregnant women on their first trimester. First ten sample was given vitamin B6 and the other ten sample were given vitamin B6 plus pisang ambon. Data were then analyzed using two independent mean difference test. Results: The result shows that in vitamin B6 consumption for hyperemesis gravidarum in 10% pregnant women were in the effective category. While in the pisang ambon consumption shows 100% of pregnant women are in the effective category. Conclusion: There is difference in effectiveness between vitamin B6 and pisang ambon consumption to overcome hyperemesis gravidarum (p=0,003<α).   Keywords: Hiperemesis gravidarum, vitamin B6, Pisang ambon

Hyperemesis Gravidarum and Thyrotoxicosis — A Diagnostic and Therapeutic Problem

1989 ◽  
Vol 34 (3) ◽  
pp. 472-473 ◽  
Author(s):  
J.A. Thomson ◽  
R. Wilson ◽  
C.G. Gray ◽  
A.C.A. Glen ◽  
D. Mack
Keyword(s):  
Early Pregnancy ◽  
Thyroid Dysfunction ◽  
Hyperemesis Gravidarum ◽  
First Trimester ◽  
Antithyroid Therapy ◽  
Spontaneous Improvement ◽  
Therapeutic Problem ◽  
Uneventful Pregnancy ◽  
In Pregnancy

We report a case of hyperemesis gravidarum complicated by thyrotoxicosis which was managed conservatively during pregnancy. Problems of diagnosing mild thyrotoxicosis in pregnancy are discussed. Although no specific antithyroid therapy was given, the patient had an uneventful pregnancy after the first trimester. Neither she nor her baby exhibited any subsequent features of thyroid dysfunction. This suggests that treatment of thyrotoxicosis in early pregnancy is not always required because of the spontaneous improvement which is likely to occur as pregnancy progresses.

scholarly journals Impact of Covid-19 in pregnancy on mother’s psychological status and infant’s neurobehavioral development: a longitudinal cohort study in China

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Yuanyuan Wang ◽  
Lian Chen ◽  
Tianchen Wu ◽  
Huifeng Shi ◽  
Qin Li ◽  
...  
Keyword(s):  
Cohort Study ◽  
Maternal Mental Health ◽  
Healthcare Providers ◽  
First Trimester ◽  
Psychological Disorder ◽  
Psychological Status ◽  
Post Traumatic Stress ◽  
Breastfeeding Rate ◽  
Long Term Impact ◽  
In Pregnancy

Abstract Background Evidence concerning the long-term impact of Covid-19 in pregnancy on mother’s psychological disorder and infant’s developmental delay is unknown. Methods This study is a longitudinal single-arm cohort study conducted in China between May 1 and July 31, 2020. Seventy-two pregnant patients with Covid-19 participated in follow-up surveys until 3 months after giving birth (57 cases) or having abortion (15 cases). We collected data from medical records regarding Covid-19, delivery or abortion, testing results of maternal and neonatal specimens, and questionnaires of quarantine, mother–baby separation, feeding, and measuring of mothers’ mental disorders and infants’ neurobehavioral disorders. Results All cases infected in the first trimester and 1/3 of cases infected in the second trimester had an abortion to terminate the pregnancy. 22.2% of pregnant patients were suffering from post-traumatic stress disorder or depression at 3 months after delivery or induced abortion. Among 57 live births, only one neonate was positive of nucleic acid testing for throat swab, but negative in repeated tests subsequently. The median duration of mother–baby separation was 35 days (interquartile range 16 to 52 days). After the termination of maternal quarantine, 49.1% of mothers chose to prolong the mother–baby separation (median 8 days; IQR 5 to 23 days). The breastfeeding rate was 8.8% at 1 week after birth, 19.3% at the age of 1 month, and 36.8% at the age of 3 months, respectively. The proportion of “monitoring” and “risk” in the social–emotional developmental domain at the age of 3 months was 22.7% and 63.6%, respectively. After the adjustment of preterm, neonatal sex, admitted to NICU, and the mother’s Covid-19 condition, the negative associations were significantly identified (p < 0.05) between mother–baby separation days and three developmental domains: communication, gross motor, and personal–social. Conclusions There is no definite evidence on vertical transmission of SARS-CoV-2. In addition to control infection risk, researchers and healthcare providers should pay more attention to maternal mental health and infant’s feeding, closeness with parents, and early development.

scholarly journals Pregnancy Outcome after Varenicline Exposure in the First Trimester

2014 ◽  
Vol 2014 ◽  
pp. 1-2
Author(s):  
Yusuf Cem Kaplan ◽  
Nihal Olgac Dündar ◽  
Burcu Kasap ◽  
Barıs Karadas
Keyword(s):  
Case Report ◽  
Unplanned Pregnancy ◽  
Fetal Echocardiography ◽  
First Trimester ◽  
Limited Data ◽  
Fetal Ultrasound ◽  
First Case ◽  
Age Appropriate ◽  
Gestational Week ◽  
In Pregnancy

To the best of our knowledge this is the first case report describing exposure to varenicline, anα4β2nicotinic acetylcholine partial receptor agonist used for smoking cessation therapy in pregnancy. A 29-year-old multiparous woman with an unplanned pregnancy has used varenicline 2 mg/day unintentionally yet regularly 4 weeks from her last menstrual period. Fetal ultrasound performed at each trimester, detailed anomaly scan, and fetal echocardiography which were performed at the 22nd gestational week showed normal fetal growth with no malformations. The patient delivered a healthy baby at the 38th week of gestation with normal Apgar score and physical examination findings. Age-appropriate physical and neurological development of the child has been observed for 6 months. Although it is not possible to draw definitive conclusions, this case report may contribute to the current available limited data regarding the safety of varenicline use in pregnancy.

scholarly journals Saving the Fetus in Maternal Schizophrenia: The Role and Safety of Electroconvulsive Therapy (ECT) in Pregnancy.

2018 ◽  
Vol 1 (1) ◽  
pp. 48-52
Author(s):  
Othman Abdul Karim ◽  
Noraslawati R ◽  
Anisah J ◽  
Syaratul Emma H
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Electroconvulsive Therapy ◽  
First Trimester ◽  
Treatment Resistant ◽  
Pharmacological Interventions ◽  
Antipsychotic Medications ◽  
Long Duration ◽  
Clinical Dilemma ◽  
In Pregnancy

Introduction: Managing schizophrenia during pregnancy often presents a clinical dilemma. Although pharmacological interventions are mostly effective for these disorders during pregnancy, there are few drawbacks for this approach. The potential teratogenicity and long duration of interventions required to control the symptoms somehow limits its usage during pregnancy.Here we described a case report of treatment-resistant schizophrenia successfully treated with ECT without obvious complication to the mother and her baby.Conclusion: Electroconvulsive therapy is an ideal alternative treatment for a patient with schizophrenia during pregnancy. ECT also will eliminate the potential side effects of antipsychotic medications on the mother and teratogenicity effect to the fetus, especially during the first trimester.

Malignant Primary Hypertension in Pregnancy Treated with Lisinopril

2000 ◽  
Vol 34 (2) ◽  
pp. 180-182 ◽  
Author(s):  
Antony J Tomlinson ◽  
James Campbell ◽  
James J Walker ◽  
Colin Morgan
Keyword(s):  
Renal Failure ◽  
Case Report ◽  
Necrotizing Enterocolitis ◽  
Ace Inhibitors ◽  
Ace Inhibitor ◽  
Neonatal Outcome ◽  
First Trimester ◽  
Successful Outcome ◽  
Chronic Hypertension ◽  
In Pregnancy

OBJECTIVE: To report a case of a patient treated with an angiotensin-converting enzyme (ACE) inhibitor with a good neonatal outcome. CASE REPORT: A 39-year-old African-Caribbean patient who had chronic hypertension presented at 18 weeks' gestation with acute hypertension. She was being treated for chronic hypertension with lisinopril, but had self-discontinued treatment. Attempts to control her hypertension with labetolol, nifedipine, and methyldopa were ineffective. She was therefore offered termination of pregnancy so treatment with lisinopril could be restarted. The patient elected to continue with the pregnancy in spite of the fetal risks associated with the use of an ACE inhibitor. She was delivered of a girl at 26 weeks' gestation. The baby initially had renal failure and also developed acute necrotizing enterocolitis. The renal failure improved simultaneously with the latter complication, and it is postulated that there was enteric excretion of lisinopril. The baby was discharged home on day 102 with no further complications. DISCUSSION: ACE inhibitors are acceptable medications to use in the first trimester of pregnancy; however, fetal malformations and neonatal complications have been associated with their use later in pregnancy, and they have a perinatal mortality rate of 97/1000. Lisinopril is excreted in urine and feces unchanged, and its half-life is prolonged in anuric neonates. Peritoneal dialysis eliminates lisinopril; however, this neonate improved after treatment for necrotizing enterocolitis and simultaneous improvement in bowel function. CONCLUSIONS: ACE inhibitors should not be used in pregnancy beyond the end of the first trimester. In exceptional cases, they may be indicated for the control of severe hypertension when the patient is refractory to other medications. The patient should be fully counseled about the adverse effect profile and neonatal outcome. This case report documents a successful outcome for mother and baby in these circumstances.

DIAGNOSIS AND MANAGEMENT OF NAUSEA AND VOMITING IN PREGNANCY

2006 ◽  
Vol 17 (1) ◽  
pp. 45-67 ◽  
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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