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

  title={Treatments for hyperemesis gravidarum and nausea and vomiting in pregnancy: a systematic review and economic assessment.},
  author={Amy J O'Donnell and Catherine McParlin and Stephen Courtenay Robson and Fiona R Beyer and Eoin Moloney and Andrew Bryant and Jennifer L. Bradley and Colin Muirhead and Catherine Nelson-Piercy and Dorothy Newbury-Birch and Justine Norman and Emma L. Simpson and Brian L. Swallow and Laura Yates and Luke Vale},
  journal={Health technology assessment},
  volume={20 74},
BACKGROUND Nausea 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. OBJECTIVES This study aimed to determine the relative clinical effectiveness and cost-effectiveness of treatments for NVP and HG. DATA SOURCES… 
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This Primer provides a comprehensive review of the current state of basic science and clinical knowledge on nausea and vomiting of pregnancy, and its extreme form hyperemesis gravidarum.
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There is considerable variation in current management practices for NVP outside of recently published guidelines, and this may result in substantial resource use and avoidable financial impact to the NHS.
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The large Scandinavian study found no association between HG and incidence of 12 types of childhood malignancies, only increased the incidence of lymphoma and testicular tumor was found which need further studies to confirm this causal relation.
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An internationally accepted definition and the formulation of core outcomes would facilitate meta-analysis of trial results and implementation of evidence in guidelines to ultimately improve patient care.
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Further training for all clinicians and earlier recognition of malnutrition, alongside investment in the role of dietitians were recommended to improve the nutritional care of those with HG.
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Evidence of non-pharmacological methods that can be used as an alternative to conquer nausea and vomiting of pregnancy, namely ginger, acupressure, acupuncture, and aromatherapy are provided.


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