(Green-top Guideline No. 69)
NVP affects up to 90% of pregnant women and is one of the most common indications for hospital admission among pregnant women, with typical stays of between three and four days.
The major mechanism of NVP and HG has recently been elucidated to be related to hypersensitivity to the vomiting hormone growth differentiation factor-15(GDF15).
GDF15 caused loss of appetite, taste aversion, nausea, vomiting and weight loss.
Higher circulating levels of GDF15 and not hCG were found in hospitalised HG patients, patients taking medication for NVP, and patients with 2nd trimester vomiting.
HOW A R E N V P A N D HG DEFINED AND DIAGNOSED?
NVP typically starts between the 4th and 7th weeks of gestation, peaks in approximately the 9th week and resolves by the 20th week in 90% of women.
HG is a severe form of NVP, which affects between 0.3 and
3.6% of pregnant women, interfering with quality of life and
the ability to eat and drink normally.
The
Windsor definition describes HG as nausea and vomiting
of which one is severe, beginning in early pregnancy (before
16weeks of gestation), inability to eat and drink normally, and
strongly limiting daily living activities.
Liver function tests are abnormal in up to 40% of women
with HG.
HOW SHOULD WOMEN WITH NVP AND HG BE CARED FOR?
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