What is pregnancy drama vomiting
Pregnancy spitting (HG) refers to severe nausea and vomiting in early pregnancy pregnant women, and cause dehydration, ketone and even acidosis, which requires hospitalization.
About 50%of pregnant women in the early pregnancy will have nausea and vomiting, 25%only have nausea and no vomiting, and 25%asymptomatic.These symptoms are mostly in 4 weeks of pregnancy, and the most severe at 9 weeks of pregnancy; 60 % of pregnant women are relieved by their own symptoms 12 weeks after 12 weeks of pregnancy, 91 % of pregnant women are relieved after 20 weeks of pregnancy, and about 10 % of pregnant women continue to nausea and vomit during pregnancy.EssenceThe recurrence rate of nausea and vomiting is 15.2%to 81.0%again.Pregnant women with nausea and vomiting usually have only 0.3%to 1.0%of pregnancy drama vomiting. Whether hospitalization is often used as one of the important basis for clinical judgment of pregnancy drama.Pregnant women with pregnancy drama have decreased, and the decline is even more than 5%before the onset of the disease. Symptoms such as obvious weight loss, extreme fatigue, dry lips, dry skin, eye depression, and decreased urine volume.
The cause of pregnancy drama vomiting
1. The increase in the premature early pregnancy response of chorionic gonadotropin (HCG) levels is consistent with the disappearance time and the blood HCG level. Moreover, the level of women’s blood HCG with increased quality of placenta rises, and the incidence of severe vomiting is also high.2. Changes in thyroid function 60%of patients will have temporary hyperthyroidism, and vomiting is closely related to free thyroid hormones.3. Genetic studies have shown that GDF15 and IGFBP7 are related to the vomiting of pregnancy drama. It is found that there are significant sites in the related research of the whole genome. It involves the two genes of GDF15 and IGFBP7, both related to evil quality and appetite.GDF15 is closely related to family and recurrent pregnancy drama.The GDF15-GFRAL shaft is currently considered by most researchers as the "most likely pathogenesis".4. The study of Helicobacter pylori in recent years has found that there is a correlation between H. pylori positive and pregnancy drama vomiting.Helicobacter pylori is an independent risk factor for pregnancy vomiting.5. Pregnancy vomiting in pregnant women with poor mental stress, anxiety, depression, and poor living environment and economic conditions.
Pregnancy drama vomiting complications
60%to 70%of pregnancy drama vomiting pregnant women may have a short-term hyperthyroidism (hyperthyroidism), which is manifested as a decrease in thyroid hormone (TSH) levels or rising from T4.The chemical structure is similar. After pregnancy, the level of β-HCG rises, stimulates the secretion of thyroid hormone in the thyroid gland, and then feedback to inhibit the TSH level.It is often temporary and generally does not need to use anti -nor nortoma drugs.Patients with primary hyperthyroidism rarely vomit, while pregnancy drama vomiting pregnant women do not have the clinical manifestations of hyperthyroidism (such as thyroidistness) or thyroid antibodies. The thyroid function should be checked at 20 weeks of pregnancy. The level of thyroid hormone is usually returned to normal.
Wernicke brain disease
Generally, the disease occurs after 3 weeks of pregnancy, which is caused by serious lack of vitamin B1 caused by severe vomiting.About 10 % of patients with pregnancy drama vomiting are concurrent, mainly characterized by eye muscle paralysis, torso disorders and forgotten mental symptoms.The clinical manifestations are eye tremor, visual obstacles, gait and standing positions, and can occur in individual stiffness or coma.The mortality rate of patients is still 10%after treatment, and the mortality rate of non -therapy is as high as 50%.
Principles of pregnancy drama vomiting treatment
Specifications, maintaining body fluid and electrolyte balance, including non -drug therapy and drug treatment.
1. General treatment
Try to avoid contact with the smell, food or additives that are easily induced by vomiting.Avoid an empty stomach in the morning, encourage a small amount of meals, avoid full stomach, avoid spicy and greasy foods, drink water between two meals, eat light, high -protein foods and salty biscuits.Chewing salted ginger or ginger slices, smelling loud lemon, drinking ice and sprint, dried ginger ginseng pepper, soaked in water, etc.Medical staff and family members should give patients a psychological guidance and inform them that after the pregnancy of the pregnancy drama is actively treated for 2 to 3 days, the condition improves quickly. Only a few pregnant women have recurred after discharge, and they need to be admitted to the hospital again.Proper exercise and beautiful mood are also vomiting.
2. Correct dehydration and electrolyte disorders
(1) Daily intravenous drip glucose liquid, glucose saline, physiological saline, and balance liquid total of about 3,000 mL, including vitamin B6 100 mg, vitamin C 2 to 3 g, continuous infusion at least 3 d (depending on vomiting relief and eating, eating food relief and eatingThe situation is determined), maintaining the daily urine volume ≥ 1 000 ml.You can use the glucose 4 to 5 g+insulin 1 U+10% KCL 1.0 ～ 1.5 g with a polarized liquid injecting energy, but you should pay attention to the first muscle injection (vitamin B1) 100 mgWernicke encephalopathy occurs.Those with ineffective treatment cannot maintain normal body quality. They can consider the nutrition of the nasal and gastrointestinal intestines. Varicular nutrients in the intestinal vein can only be used as the final support treatment when the aforementioned treatment is invalid.
(2) General potassium supplementation is 3 to 4 g/d. Potassium can be supplemented to 6-8 g/d when severe hypokalemia.Pay attention to observing urine volume. In principle, 1 G per 500 ml of urine volume is safer, while monitoring serum potassium levels and electrocardiogram.Properly supplement sodium carbonate or sodium lactate solution to correct metabolic acid poisoning according to blood carbon dioxide levels, and the common amount is 125-250 ml / time.
3. Turbidity treatment
Safety of antivirus: Because the vomiting of pregnancy occurs in the early pregnancy, it is the most vulnerable to teratogenic sensitive period of the fetus.
① Vitamin B6 or Vitamin B6-Dopisla Min (Anti-Min’an) Composite Preparation: Studies have confirmed that the application of pregnancy spitting during early pregnancy is safe and effective. The first line of medication, but there are no Sicilain in my country.
② Tyoxopramine (other names: stomach recovery): It is a dopamine antagonist, gastric dynamic medicine, and is effective for pregnant mothers with hot stomach and bad public.The application of methalothamine during early pregnancy did not increase the risk of fetal malformations and natural abortion. The quality of newborn births was significantly different from the normal control group.There is no risk of newborn birth defects, low birth quality, premature birth, and death of siege.
③ Angdan Siqiong (other names: Endanicone): It is a 5-hydroxyline 3 receptor antagonist. The drug does not increase natural abortion, in the palace of fetuses, newborn birth defects, premature birth, and newborn.The risk of quality and less than the age of the fetus, but there are also reports related to fetal lip cracking.Angdan Siqiong has potential risks that have increased the patient’s heart QT extension and caused the tachycardia at the end of the tip.Patients with individuals and family history of hemiamal, hypomiasis, and family history should monitor electrolytes and electrocardiogram.The intravenous drip pitaminamine is similar to the relief effect of Angdanjione Qiong, but the latter’s side reaction such as drowsiness, dry mouth, and urinary ketone incidence is lower than that of metharoxamineIts advantages in the safer, good effect and cheaper of the fetus have become another choice for pregnant women with pregnancy drama.As a final vomiting solution for patients with refractory pregnancy drama.
④ Aifnosine: The antivirus effect of isramine is basically similar to methoxamine.Although the incidence of birth defects in early pregnancy is increasing, continuous use of newborn abstaining effects and cone exterior reactions can be used in the late pregnancy.
⑤ Glycogen hormone: The pine dragon with strong methyls can relieve the symptoms of pregnancy drama vomiting, but given that the application of early pregnancy will increase the risk of fetal lip and palate, ACOG recommends avoid being used as a first -line medication before 10 weeks of pregnancy, and only as stubbornness.The final vomiting scheme of patients with pregnancy spitting.
Prevention of pregnancy drama vomiting
The treatment of pregnancy drama began to prevent prevention. Studies have found that taking composite vitamins during pregnancy may reduce medical treatment due to vomiting. Therefore, it is recommended to take composite vitamin schemes 3 months before pregnancy.At the same time, it helps prevent fetal nerve tube defects.
Termination of pregnancy indicators
(1) The body temperature continues to be higher than 38 ° C;
(2) During bed rest, heart rate> 120 times/min;
(3) Continuous jaundice or proteinuria;
(4) Multiple neuritis and neurological signs occur;
(5) Those with intracranial or bottom bleeding menstruation;
(6) Wernicke encephalopathy appears.