Nausea and vomiting during pregnancy are a common manifestation and high incidence.Among them, the incidence of nausea is 50%to 80%, the incidence of vomiting and retching is 50%, and the incidence of nausea and vomiting during pregnancy is 15.2%to 81%during pregnancy.Almost all pregnant women who have nausea and vomiting have obvious symptoms before 9 weeks of pregnancy, usually starting from 5 to 6 weeks of pregnancy, peak at 8-10 weeks, relief from 16 to 20 weeks, 15%to 20%of pregnant women will meetIt continues to alleviate until the late pregnancy, and 5%of pregnant women will continue until childbirth.
Pregnancy vomiting is a condition when nausea and vomiting during pregnancy have developed to extremely serious.Pregnant women who are nausea and vomiting are usually 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.The lack of recognition definition of pregnancy drama is a clinical diagnosis based on typical clinical manifestations that cannot be interpreted by other diseases.The most commonly used standards are as follows: persistent vomiting explained by other diseases, and acute hunger indicators are positive (usually positive urine ketone), weight loss exceeds 5%of the weight before pregnancy, may be accompanied by electrolytes, thyroid function, liver function, etc.Abnormal.
The cause of nausea and vomiting during pregnancy is unclear, and many theories have been proposed, including the theory of hormone stimulation, evolution adaptation theory, and psychological susceptibility theory.The risk factors of their onset include increased placental quality (such as advanced hydatate or multi -fetal pregnancy), family history or previous pregnancy, which has serious history of nausea and vomiting, a history of faint disease or migraine disease.
The impact of nausea and vomiting during pregnancy: 1. Impact on the mother’s body: The impact of the vomiting of pregnancy drama on the mother is greater, and often delayed the treatment or treatment due to the concerns of pregnant women’s concerns about early pregnancy.Syndic acid poisoning and other complications, even endangering the life of pregnant women, was eventually forced to terminate pregnancy.During pregnancy, there are severe complications of nausea and vomiting include Wenick brain disease, spleen rupture, esophageal rupture, pneumothorax and acute renal tube necrosis.A systematic review of a systematic psychological disease related to pregnancy drama has proved that the depression and anxiety scores of pregnant women with pregnancy drama spitting are higher.2. Effect on fetal: The effect of nausea and vomiting on embryos and fetuses during pregnancy mainly depends on the severity of the disease.Mild or moderate vomiting has little effect on the ending of pregnancy. Severe vomiting may have an impact on the fetus. The most common is low birth weight.At present, the impact of nausea and vomiting during pregnancy on pregnant women and fetal long -term health is unclear.
Treatment of nausea and vomiting during pregnancy: The "Guidelines for Nausea Vomiting and Vomiting Diagnosis (2018 Edition)" of the American Obstetrics and Gynecologists’ Society pointed out that the treatment of nausea and vomiting during pregnancy should start from prevention.If nausea and vomiting during pregnancy, early treatment is recommended, which may be conducive to preventing the progress of the disease as pregnancy spitting (Class C evidence).The clinical treatment of pregnancy drama vomiting includes non -drug therapy and drug treatment.The first -line treatment of nausea and vomiting during pregnancy is non -drug treatment.1. General treatment and psychological support treatment: Pay attention to rest, try to avoid touching the smell, heat, humidity, and flash that can easily induce vomiting, avoid eating food or additives that are prone to nausea and vomiting.Medical staff and family members should give patients a psychological guidance and inform them that the pregnancy drama vomiting meridian is actively treated for 2 to 3 days, and the condition improves quickly. Only a few pregnant women have recurred after discharge, and they need to be admitted to the hospital again.2. Conventional nutritional therapy: "Guide to Nausea and Vomiting Diagnosis and Treatment (2018 Edition)" is recommended to start to supplement vitamins 1 month before pregnancy, which can reduce the incidence and severity of pregnancy nausea and vomiting (grade evidence).Ginger can reduce the symptoms of nausea (Grade B). It is recommended to take 250mg of ginger capsules for 4 times a day.Suggestions for diet of nausea and vomiting during mild and moderate pregnancy are as follows: ① Encourage eating, mainly indigestible foods, avoid spicy and greasy foods.② Eat less meals to avoid overeating.Avoid the impact of pregnancy reactions on food intake, and let pregnant women consume as much food as possible when not vomiting, increase energy and consume more nutrients at the same time.③ Pregnancy reactions are the most obvious in the morning and after meals. You can eat harder carbohydrate foods before you get up.④ Drink less soup during dinner and drink water or drink between two meals.⑤ The phenomenon of nausea and vomiting in the afternoon of most pregnant women faded down, and she was richer in dinner. She could eat a small amount of food before going to bed.⑥ Daily intake of foods containing 130g of carbohydrates to avoid ketoia.⑦ Given vitamin B6 treatment can help relieve nausea.The safe and effective dose of vitamin B6 is 10 to 25 mg, 3 to 4 times/day, orally, and can be used as first -line drug treatment (grade evidence).⑧ Relax and adjust your emotions can help reduce early pregnancy reactions.3. In -intestinal nutrition support treatment: For pregnant women who vomit pregnancy, the necessary inside of the intestinal or extra -intestinal nutrition can help eliminate keto, maintain hydrolysis, acid and alkali balance, ensure energy supply, maintain an appropriate weight growth, avoid avoiding growth, avoidThe outcome of maternal and infant adverse pregnancy."Guidelines for nausea and vomiting during pregnancy (2018 Edition)" pointed out that patients whose drug treatment is invalid and cannot maintain weight.Level evidence).4. Intestinal nutritional support: When the patient cannot tolerate the inside of the intestine and the significant decrease in weight (or) weight (or) significantly reduces (> 5%), it is necessary to give off the nutrition of the bowel in time.Due to the severe complication of its potential pregnant women, the nutrition of extra -intestines can only be used as the final support treatment when the intestinal nutritional therapy is ineffective.For those who cannot tolerate dehydration signs that cannot tolerate the nutritional or tube feeding nutrition, intravenous supplementary treatment or supplementary intestinal nutritional support is required.
Prevention and follow -up management of pregnancy drama vomiting:
The clinical manifestations of patients with pregnancy and vomiting are mostly benign. After positive and correct treatment, the condition quickly improves and naturally retreats with the progress of pregnancy.
Pregnant women who have nausea and vomiting during pregnancy should regularly return to the nutritional clinic during pregnancy. Those with mild moderate nausea and vomiting can be diagnosed every 2 to 3 weeks.Once, it can be changed to 2 to 3 weeks after the vomiting is relieved.
At the time of retraining, the intake of carbohydrates in pregnant women’s diet, weight changes and hematuria test indicators (focus on paying attention to urine ketone, hemodema, and liver and kidney functional indicators).
For more nutritional content of maternal and child nutrition, please refer to the "Bargrade Maternal and Child Nutrition Training Manual" edited by Lai Jianqiang and Wang Zhiyi, ISBN: 978-7-03-073873-8.
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