IMR Press / CEOG / Volume 49 / Issue 10 / DOI: 10.31083/j.ceog4910231
Open Access Original Research
Demographic, Clinical, and Obstetrical Characterization of Women with Hyperemesis Gravidarum Using a More Restrictive Diagnosis
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1 Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo (FMUSP), 05403-900 São Paulo, Brazil
*Correspondence: marco.galletta@fm.usp.br; mgalletta@uol.com.br (Marco Aurélio Knippel Galletta)
These authors contributed equally.
Academic Editor: Te-Fu Chan
Clin. Exp. Obstet. Gynecol. 2022, 49(10), 231; https://doi.org/10.31083/j.ceog4910231
Submitted: 11 March 2022 | Revised: 4 May 2022 | Accepted: 10 June 2022 | Published: 28 September 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Hyperemesis gravidarum (HG) is a disease that occurs during pregnancy. It is relatively rare (0.3–3.6%), but with great potential for complications. Its diagnostic criteria still lack consensus, and most studies only establish the presence of uncontrollable vomiting, requiring hospitalization. The present study aimed to investigate its epidemiological profile and maternal and neonatal outcomes in a series of cases with more restrictive diagnostic criteria. Methods: A retrospective analysis of all cases admitted with a diagnosis of HG, according to more restrictive service criteria, was performed with a review of medical records and laboratory tests in a Brazilian university hospital. Results: HG was confirmed in 85 cases (0.39% incidence). The most frequent early symptoms included a weight loss 5% (94.4%) or 10% (63.9%), dehydration (76.5%), hyponatremia (49.4%), hypokalemia (40.5%), increased liver enzymes (46.4%), and transient hyperthyroidism (38.6%). Enteral nutrition was used in 7.1% of the patients, and parenteral nutrition in 1.2%. A large majority of patients was provided with a prescription of more than one drug, and the most used drugs were dimenhydrinate (87.1%), metoclopramide (85.9%), and ondansetron (38.8%). The average length of hospital stay was 15 days (1–145 days). Childbirth data were obtained from 40 patients, with 60% of births being cesarean deliveries, 35.3% premature births, 32% with low birth weight, and 7.5% stillbirths, with 12.5% of cases having postpartum complications. The overall rate for clinical complications was 30.5%. Conclusions: With well-defined and more restrictive criteria, we observed a high rate of obstetric and neonatal complications compared to international data. Thus, a correct diagnosis is essential for identifying this serious condition and to allow earlier treatment, reducing clinical, obstetric, and neonatal complications.

Keywords
hyperemesis gravidarum
pregnancy complications
pregnancy outcome
therapeutics
weight loss
Funding
The Jikei University Research Aid. Dr Yamaguchi
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