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Hyperemesis gravidarum, a severe and debilitating form of morning sickness during pregnancy, poses significant risks to both maternal well-being and infant health. A recent review published in the Canadian Medical Association Journal provides clinicians with valuable insights into the causes, diagnosis, and management of this challenging condition.
While nausea and vomiting are common occurrences in pregnancy, affecting up to 70% of expectant mothers, hyperemesis gravidarum represents an extreme manifestation, often resulting in profound weight loss and dehydration due to the inability to consume sufficient food and fluids.
Dr. Larissa Jansen from the Amsterdam Reproduction and Development Research Institute at Erasmus MC, Rotterdam, the Netherlands, along with her coauthors, underscores the adverse effects of hyperemesis gravidarum on maternal quality of life and the potential for short- and long-term complications for offspring. The condition places significant strain on healthcare resources, frequently necessitating hospital admissions and emergency department visits during the first trimester of pregnancy.
While the precise cause of hyperemesis gravidarum remains elusive, identified risk factors include early pregnancy, carrying a female fetus, multiple pregnancies, molar pregnancies, underlying medical conditions, and a history of the condition in previous pregnancies.
Current treatment strategies primarily focus on symptom management, involving the initiation of antiemetic medications to alleviate nausea and vomiting. Although remedies like ginger products may offer relief for mild cases, their efficacy in managing hyperemesis gravidarum remains uncertain.
Of particular note, the authors caution against the use of cannabis for hyperemesis gravidarum. Citing associations with adverse neurocognitive outcomes in infants and other pregnancy-related complications, they advocate for abstaining from cannabis use during pregnancy.
Despite advancements in understanding and treating hyperemesis gravidarum, numerous questions remain unanswered, highlighting the urgent need for further research in this area to improve both prevention and management strategies.
The review, titled “Diagnosis and treatment of hyperemesis gravidarum,” authored by Larissa A.W. Jansen, Victoria Shaw, Iris J. Grooten, Marjette H. Koot, Caitlin R. Dean, and Rebecca C. Painter, provides a comprehensive overview of the current understanding of this condition and underscores the importance of ongoing research efforts to better support expectant mothers and safeguard the health of their infants.
