ResearchObstetricsHyperemesis in pregnancy: An evaluation of treatment strategies with maternal and neonatal outcomes
Section snippets
Materials and Methods
This study was approved by the Institutional Review Board at the University of Utah and LDS Hospitals. International Classification of Diseases, Ninth Revision (ICD-9) codes for nausea and vomiting in pregnancy and hyperemesis (643.01-.09) were used to identify a cohort of patients admitted for treatment from 1998 to 2004. Inclusion criteria included a singleton viable intrauterine pregnancy documented by first-trimester ultrasound; at least 1 24 hour admission to the hospital for treatment of
Results
Between 1998 and 2004, 129 patients were identified at 2 large urban tertiary medical centers. Of these, 35 patients, meeting initial requirements for inclusion, were excluded from the analysis for maternal gastrointestinal illness, unknown maternal or fetal outcome secondary to delivery at outside facility or management with a nasogastric/nasoduodenal tube, and a PICC line. Of the 94 remaining patients, 33 had a PICC line placed (35.1%), 19 had a nasogastric/nasoduodenal tube placed (20.2%),
Comment
There were striking differences between the groups concerning maternal complications. Our study reveals serious complications of bacteremia, sepsis, and thrombosis observed in a majority of the patients in the PICC line group. In several cases, these complications were severe enough to require admission to an intensive care unit and rigorous therapeutic interventions. All of the patients experiencing either infection or thrombosis required antibiotic or anticoagulant therapy. In addition, since
References (8)
- et al.
Complications associated with peripherally inserted central catheter use during pregnancy
Am J Obstet Gynecol
(2003) - et al.
Venous thrombosis associated with the placement of peripherally inserted central catheters
J Vasc Interv Radiol
(2000) - et al.
Nasogastric enteral feeding in the management of hyperemesis gravidarum
Obstet Gynecol
(1996) Hyperemesis gravidarum: epidemiologic findings from a large cohort
Am J Obstet Gynecol
(2005)
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Cite this article as: Holmgren C, Aagaard-Tillery KM, Silver RM, et al. Hyperemesis in pregnancy: An evaluation of treatment strategies with maternal and neonatal outcomes. Am J Obstet Gynecol 2008;198:56.e1-56.e4.