docruДоктор.РуTitle1727-23782713-2994ООО "ГК "РУСМЕДИКАЛ"10.31550/1727-2378-2025-24-5-93-100docru-366Research ArticleОБЗОРЫREVIEWSСовременные подходы к лечению рвоты беременных: обзор клинических рекомендацийModern Approaches to the Treatment of Vomiting in Pregnant Women: Review of Clinical Recommendationshttps://orcid.org/0000-0002-9813-2823БарановИ. И.BaranovI. I.

Баранов Игорь Иванович — д. м. н., профессор, заведующий отделом научно-образовательных программ 

Москва

Moscow

i_baranov@oparina4.ruКлименченкоН. И.KlimenchenkoN. I.

Клименченко Наталья Ивановна — к. м. н., старший научный сотрудник 1-го акушерского отделения патологии беременности 

Москва

Moscow

n_klimenchenko@oparina4.ruhttps://orcid.org/0009-0007-8960-4829ЛимоноваЕ. М.LimonovaE. M.

Лимонова Елизавета Михайловна — ординатор 2-го года отделения патологии беременности 

Москва

Moscow

Limoninskay@gmail.comhttps://orcid.org/0000-0001-6589-5245РобертусА. И.RobertusA. I.

Робертус Александра Игоревна — к. б. н., доцент кафедры фармации 

Москва

Moscow

spirea@mail.ruФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова» Минздрава РоссииРоссияNational Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. KulakovRussian FederationФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Минздрава РоссииРоссияN.I. Pirogov Russian National Research Medical UniversityRussian Federation202513112025245ГИНЕКОЛОГИЯ93100Copyright © Баранов И.И., Клименченко Н.И., Лимонова Е.М., Робертус А.И., 20252025Баранов И.И., Клименченко Н.И., Лимонова Е.М., Робертус А.И.Baranov I.I., Klimenchenko N.I., Limonova E.M., Robertus A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://docru.elpub.ru/jour/article/view/366Цель

Цель. Оценить актуальные подходы к лечению рвоты беременных на основании современных клинических рекомендаций.

Основные положения

Основные положения. Тошнота, рвота, снижение аппетита и изменение вкусовых ощущений — частые спутники беременности. Такие расстройства встречаются у 80-90% женщин. В большинстве случаев они не требуют медицинского вмешательства. Однако у некото­рых пациенток развивается тяжелая рвота (hyperemesis gravidarum). Это состояние опасно для матери и плода, поэтому требуется его активное лечение.

Заключение

Заключение. Анализ российских и международных рекомендаций по медикаментозному лечению рвоты беременных показал согласо­ванность и приверженность к единым подходам к выбору терапии, основанным на принципах ее безопасности, этапности и индивидуа­лизации.

Aim

Aim. To evaluate current approaches to the treatment of vomiting in pregnant based on modern clinical guidelines.

Key points

Key points. Nausea, vomiting, decreased appetite and changes in taste sensations are frequent companions of pregnancy. Such disorders occur in 80-90% of women. In most cases, they do not require medical intervention. However, some patients develop severe vomiting (hyperemesis gravidarum). This condition is dangerous for both the mother and the fetus, so it requires active treatment.

Conclusion

Conclusion. The analysis of Russian and international approaches to the treatment of vomiting in pregnant women shows adherence to uniform principles of therapy and good consistency in the recommendations for choosing treatment based on the principle of safety, stepby-step and individualization.

тошнота и рвота беременныхчрезмерная рвота беременныхосложнения беременностиклинические рекомендациикомбинация доксиламина и пиридоксинаvomitingnauseahyperemesis gravidarumpregnancy complicationsclinical recommendationscombination of doxylamine and pyridoxineСтатья подготовлена при поддержке АО «Валента Фарм»The article was prepared with the support of the company Valenta PharmReferencesGadsby R., Rawson V., Dziadulewicz E., Rousseau B. et al. Nausea and vomiting of pregnancy and resource implications: the NVP Impact Study. Br. J. Gen. Pract. 2019;69(680):e217–23. DOI: 10.3399/bjgp18X700745Gadsby R., Rawson V., Dziadulewicz E., Rousseau B. et al. Nausea and vomiting of pregnancy and resource implications: the NVP Impact Study. Br. J. Gen. Pract. 2019;69(680):e217–23. DOI: 10.3399/bjgp18X700745Gadsby R., Barnie-Adshead A.M., Jagger C. A prospective study of nausea and vomiting during pregnancy. Br. J. Gen. Pract. 1993;43(371):245– 8. Erratum in: Br. J. Gen. Pract. 1993;43(373):325.Gadsby R., Barnie-Adshead A.M., Jagger C. A prospective study of nausea and vomiting during pregnancy. Br. J. Gen. Pract. 1993;43(371):245– 8. Erratum in: Br. J. Gen. Pract. 1993;43(373):325.Brown H.L. Nausea and vomiting of pregnancy. Contemp. Ob. Gyn. 2016;61(4):48–50.Brown H.L. Nausea and vomiting of pregnancy. Contemp. Ob. Gyn. 2016;61(4):48–50.Kramer J., Bowen A., Stewart N., Muhajarine N. Nausea and vomiting of pregnancy. MCN Am. J. Matern. Child Nurs. 2013;38(1):21–7. DOI: 10.1097/NMC.0b013e3182748489Kramer J., Bowen A., Stewart N., Muhajarine N. Nausea and vomiting of pregnancy. MCN Am. J. Matern. Child Nurs. 2013;38(1):21–7. DOI: 10.1097/NMC.0b013e3182748489Gadsby R., Ivanova D., Trevelyan E., Hutton J.L. et al. Nausea and vomiting in pregnancy is not just ‘morning sickness’: data from a prospective cohort study in the UK. Br. J. Gen. Pract. 2020;70(697):e534–9. DOI: 10.3399/bjgp20X710885Gadsby R., Ivanova D., Trevelyan E., Hutton J.L. et al. Nausea and vomiting in pregnancy is not just ‘morning sickness’: data from a prospective cohort study in the UK. Br. J. Gen. Pract. 2020;70(697):e534–9. DOI: 10.3399/bjgp20X710885Jansen L.A.W., Koot M.H., Van’t Hooft J., Dean C.R. et al. The Windsor definition for hyperemesis gravidarum: a multistakeholder international consensus definition. Eur. J. Obstet. Gynecol. Reprod. Biol. 2021;266:15–22. DOI: 10.1016/j.ejogrb.2021.09.004Jansen L.A.W., Koot M.H., Van’t Hooft J., Dean C.R. et al. The Windsor definition for hyperemesis gravidarum: a multistakeholder international consensus definition. Eur. J. Obstet. Gynecol. Reprod. Biol. 2021;266:15–22. DOI: 10.1016/j.ejogrb.2021.09.004Garg R., Sanjay, Das V., Usman K. et al. Spontaneous pneumothorax: an unusual complication of pregnancy — a case report and review of literature. Ann. Thorac. Med. 2008;3(3):104–5. DOI: 10.4103/1817-1737.41915Garg R., Sanjay, Das V., Usman K. et al. Spontaneous pneumothorax: an unusual complication of pregnancy — a case report and review of literature. Ann. Thorac. Med. 2008;3(3):104–5. DOI: 10.4103/1817-1737.41915Joshi A., Chadha G., Narayanan P. From discomfort to distress: a critical analysis of hyperemesis gravidarum in the emergency room. Cureus. 2023;15(8):e44004. DOI: 10.7759/cureus.44004Joshi A., Chadha G., Narayanan P. From discomfort to distress: a critical analysis of hyperemesis gravidarum in the emergency room. Cureus. 2023;15(8):e44004. DOI: 10.7759/cureus.44004Goodwin T.M., Montoro M., Mestman J.H. Transient hyperthyroidism and hyperemesis gravidarum: clinical aspects. Am. J. Obstet. Gynecol. 1992;167(3):648–52. DOI: 10.1016/s0002-9378(11)91565-8Goodwin T.M., Montoro M., Mestman J.H. Transient hyperthyroidism and hyperemesis gravidarum: clinical aspects. Am. J. Obstet. Gynecol. 1992;167(3):648–52. DOI: 10.1016/s0002-9378(11)91565-8Fejzo M.S., Sazonova O.V., Sathirapongsasuti J.F., Hallgrímsdóttir I.B. et al. Placenta and appetite genes GDF15 and IGFBP7 are associated with hyperemesis gravidarum. Nat. Commun. 2018;9(1):1178. DOI: 10.1038/s41467-018-03258-0Fejzo M.S., Sazonova O.V., Sathirapongsasuti J.F., Hallgrímsdóttir I.B. et al. Placenta and appetite genes GDF15 and IGFBP7 are associated with hyperemesis gravidarum. Nat. Commun. 2018;9(1):1178. DOI: 10.1038/s41467-018-03258-0Fejzo M., Arzy D., Tian R., MacGibbon K. et al. Evidence GDF15 plays a role in familial and recurrent hyperemesis gravidarum. Geburtshilfe Frauenheilkd. 2018;78(09):866–70. DOI: 10.1055/a-0661-0287Fejzo M., Arzy D., Tian R., MacGibbon K. et al. Evidence GDF15 plays a role in familial and recurrent hyperemesis gravidarum. Geburtshilfe Frauenheilkd. 2018;78(09):866–70. DOI: 10.1055/a-0661-0287Fejzo M., Rocha N., Cimino I., Lockhart S. et al. Fetally-encoded GDF15 and maternal GDF15 sensitivity are major determinants of nausea and vomiting in human pregnancy. bioRxiv [Preprint]. 2023:2023.06.02.542661. DOI: 10.1101/2023.06.02.542661Fejzo M., Rocha N., Cimino I., Lockhart S. et al. Fetally-encoded GDF15 and maternal GDF15 sensitivity are major determinants of nausea and vomiting in human pregnancy. bioRxiv [Preprint]. 2023:2023.06.02.542661. DOI: 10.1101/2023.06.02.542661Fejzo M.S., MacGibbon K.W., First O., Quan C. et al. Whole-exome sequencing uncovers new variants in GDF15 associated with hyperemesis gravidarum. BJOG. 2022;129(11):1845–52. DOI: 10.1111/1471-0528.17129Fejzo M.S., MacGibbon K.W., First O., Quan C. et al. Whole-exome sequencing uncovers new variants in GDF15 associated with hyperemesis gravidarum. BJOG. 2022;129(11):1845–52. DOI: 10.1111/1471-0528.17129Nelson-Piercy C., Dean C., Shehmar M., Gadsby R. et al. The management of nausea and vomiting in pregnancy and hyperemesis gravidarum (Green-top Guideline No. 69). BJOG. 2024;131(7):e1– 30. DOI: 10.1111/1471-0528.17739Nelson-Piercy C., Dean C., Shehmar M., Gadsby R. et al. The management of nausea and vomiting in pregnancy and hyperemesis gravidarum (Green-top Guideline No. 69). BJOG. 2024;131(7):e1– 30. DOI: 10.1111/1471-0528.17739Veenendaal M.V.E., van Abeelen A.F.M., Painter R.C., van der Post J.A.M. et al. Consequences of hyperemesis gravidarum for offspring: a systematic review and meta-analysis. BJOG. 2011;118(11):1302– 13. DOI: 10.1111/j.1471-0528.2011.03023.xVeenendaal M.V.E., van Abeelen A.F.M., Painter R.C., van der Post J.A.M. et al. Consequences of hyperemesis gravidarum for offspring: a systematic review and meta-analysis. BJOG. 2011;118(11):1302– 13. DOI: 10.1111/j.1471-0528.2011.03023.xTan A., Foran T., Henry A. Managing nausea and vomiting in pregnancy in a primary care setting. Aust. Fam. Physician. 2016;45(8):564–8.Tan A., Foran T., Henry A. Managing nausea and vomiting in pregnancy in a primary care setting. Aust. Fam. Physician. 2016;45(8):564–8.Depue R.H., Bernstein L., Ross R.K., Judd H.L. et al. Hyperemesis gravidarum in relation to estradiol levels, pregnancy outcome, and other maternal factors: a seroepidemiologic study. Am. J. Obstet. Gynecol. 1987;156(5):1137–41. DOI: 10.1016/0002-9378(87)90126-8Depue R.H., Bernstein L., Ross R.K., Judd H.L. et al. Hyperemesis gravidarum in relation to estradiol levels, pregnancy outcome, and other maternal factors: a seroepidemiologic study. Am. J. Obstet. Gynecol. 1987;156(5):1137–41. DOI: 10.1016/0002-9378(87)90126-8Rhodes V.A., McDaniel R.W. The index of nausea, vomiting, and retching: a new format of the index of nausea and vomiting. Oncol. Nurs. Forum. 1999;26(5):889–94.Rhodes V.A., McDaniel R.W. The index of nausea, vomiting, and retching: a new format of the index of nausea and vomiting. Oncol. Nurs. Forum. 1999;26(5):889–94.Rhodes V.A., Watson P.M., Johnson M.H. Development of reliable and valid measures of nausea and vomiting. Cancer Nurs. 1984;7(1):33–41.Rhodes V.A., Watson P.M., Johnson M.H. Development of reliable and valid measures of nausea and vomiting. Cancer Nurs. 1984;7(1):33–41.Koren G., Boskovic R., Hard M., Maltepe C. et al. Motherisk-PUQE (pregnancy-unique quantification of emesis and nausea) scoring system for nausea and vomiting of pregnancy. Am. J. Obstet. Gynecol. 2002;186(5 suppl. understanding):S228–31. DOI: 10.1067/mob.2002.123054Koren G., Boskovic R., Hard M., Maltepe C. et al. Motherisk-PUQE (pregnancy-unique quantification of emesis and nausea) scoring system for nausea and vomiting of pregnancy. Am. J. Obstet. Gynecol. 2002;186(5 suppl. understanding):S228–31. DOI: 10.1067/mob.2002.123054Koren G., Piwko C., Ahn E., Boskovic R. et al. Validation studies of the Pregnancy Unique-Quantification of Emesis (PUQE) scores. J. Obstet. Gynaecol. 2005;25(3):241–4. DOI: 10.1080/01443610500060651Koren G., Piwko C., Ahn E., Boskovic R. et al. Validation studies of the Pregnancy Unique-Quantification of Emesis (PUQE) scores. J. Obstet. Gynaecol. 2005;25(3):241–4. DOI: 10.1080/01443610500060651Lacasse A., Rey E., Ferreira E., Morin C. et al. Validity of a modified Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) scoring index to assess severity of nausea and vomiting of pregnancy. Am. J. Obstet. Gynecol. 2008;198(1):71.e1–7. DOI: 10.1016/j.ajog.2007.05.051Lacasse A., Rey E., Ferreira E., Morin C. et al. Validity of a modified Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) scoring index to assess severity of nausea and vomiting of pregnancy. Am. J. Obstet. Gynecol. 2008;198(1):71.e1–7. DOI: 10.1016/j.ajog.2007.05.051Ebrahimi N., Maltepe C., Bournissen F.G., Koren G. Nausea and vomiting of pregnancy: using the 24-hour Pregnancy-Unique Quantification of Emesis (PUQE-24) scale. J. Obstet. Gynaecol. Can. 2009;31(9):803–7. DOI: 10.1016/S1701-2163(16)34298-0Ebrahimi N., Maltepe C., Bournissen F.G., Koren G. Nausea and vomiting of pregnancy: using the 24-hour Pregnancy-Unique Quantification of Emesis (PUQE-24) scale. J. Obstet. Gynaecol. Can. 2009;31(9):803–7. DOI: 10.1016/S1701-2163(16)34298-0MacGibbon K.W., Kim S., Mullin P.M., Fejzo M.S. HyperEmesis Level Prediction (HELP Score) identifies patients with indicators of severe disease: a validation study. Geburtshilfe Frauenheilkd. 2021;81(1):90–8. DOI: 10.1055/a-1309-1997MacGibbon K.W., Kim S., Mullin P.M., Fejzo M.S. HyperEmesis Level Prediction (HELP Score) identifies patients with indicators of severe disease: a validation study. Geburtshilfe Frauenheilkd. 2021;81(1):90–8. DOI: 10.1055/a-1309-1997Савельева Г.М., Сухих Г.Т., Серов В.Н., Радзинский В.Е., ред. Акушерство: национальное руководство. 2-е изд. М.: ГЭОТАРМедиа; 2022. 1080 с.Savelyeva G.M., Sukhikh G.T., Serov V.N., Radzinsky V.E., eds. Obstetrics: national leadership. 2nd ed. M.: GEOTAR-Media; 2022. 1080 p. (in Russian)Ezberci İ., Güven E.S.G., Ustüner I., Sahin F.K. et al. Disability and psychiatric symptoms in hyperemesis gravidarum patients. Arch. Gynecol. Obstet. 2014;289(1):55–60. DOI: 10.1007/s00404-013-2934-5Ezberci İ., Güven E.S.G., Ustüner I., Sahin F.K. et al. Disability and psychiatric symptoms in hyperemesis gravidarum patients. Arch. Gynecol. Obstet. 2014;289(1):55–60. DOI: 10.1007/s00404-013-2934-5Koot M.H., Grooten I.J., Post J.A.M.V., Bais J.M.J. et al. Ketonuria is not associated with hyperemesis gravidarum disease severity. Eur. J. Obstet. Gynecol. Reprod. Biol. 2020;254 315–20. DOI: 10.1016/j.ejogrb.2020.08.014Koot M.H., Grooten I.J., Post J.A.M.V., Bais J.M.J. et al. Ketonuria is not associated with hyperemesis gravidarum disease severity. Eur. J. Obstet. Gynecol. Reprod. Biol. 2020;254 315–20. DOI: 10.1016/j.ejogrb.2020.08.014Mitchell-Jones N., Gallos I., Farren J., Tobias A. et al. Psychological morbidity associated with hyperemesis gravidarum: a systematic review and meta-analysis. BJOG. 2017;124(1):20–30. DOI: 10.1111/1471-0528.14180Mitchell-Jones N., Gallos I., Farren J., Tobias A. et al. Psychological morbidity associated with hyperemesis gravidarum: a systematic review and meta-analysis. BJOG. 2017;124(1):20–30. DOI: 10.1111/1471-0528.14180Fiaschi L., Nelson-Piercy C., Gibson J., Szatkowski L. et al. Adverse maternal and birth outcomes in women admitted to hospital for hyperemesis gravidarum: a population-based cohort study. Paediatr. Perinat. Epidemiol. 2018;32(1):40–51. DOI: 10.1111/ppe.12416Fiaschi L., Nelson-Piercy C., Gibson J., Szatkowski L. et al. Adverse maternal and birth outcomes in women admitted to hospital for hyperemesis gravidarum: a population-based cohort study. Paediatr. Perinat. Epidemiol. 2018;32(1):40–51. DOI: 10.1111/ppe.12416Petry C.J., Ong K.K., Beardsall K., Hughes I.A. et al. Vomiting in pregnancy is associated with a higher risk of low birth weight: a cohort study. BMC Pregnancy Childbirth. 2018;18(1):133. DOI: 10.1186/s12884-018-1786-1Petry C.J., Ong K.K., Beardsall K., Hughes I.A. et al. Vomiting in pregnancy is associated with a higher risk of low birth weight: a cohort study. BMC Pregnancy Childbirth. 2018;18(1):133. DOI: 10.1186/s12884-018-1786-1Jarvis S., Nelson-Piercy C. Management of nausea and vomiting in pregnancy. BMJ. 2011;342:d3606. DOI: 10.1136/bmj.d3606Jarvis S., Nelson-Piercy C. Management of nausea and vomiting in pregnancy. BMJ. 2011;342:d3606. DOI: 10.1136/bmj.d3606Koren G., Hankins G.D.V., Clark S., Caritis S.N. et al. Effectiveness of doxylamine-pyridoxine for morning sickness. Am. J. Obstet. Gynecol. 2016;214(5):664–6. DOI: 10.1016/j.ajog.2016.01.186Koren G., Hankins G.D.V., Clark S., Caritis S.N. et al. Effectiveness of doxylamine-pyridoxine for morning sickness. Am. J. Obstet. Gynecol. 2016;214(5):664–6. DOI: 10.1016/j.ajog.2016.01.186Erick M., Cox J.T., Mogensen K.M. ACOG Practice Bulletin 189: nausea and vomiting of pregnancy. Obstet. Gynecol. 2018;131(5):935. DOI: 10.1097/AOG.0000000000002604Erick M., Cox J.T., Mogensen K.M. ACOG Practice Bulletin 189: nausea and vomiting of pregnancy. Obstet. Gynecol. 2018;131(5):935. DOI: 10.1097/AOG.0000000000002604Smith J.A., Fox K.A., Clark S.M. Nausea and vomiting of pregnancy: treatment and outcome. UptoDate 2023. URL: https://www.uptodate.com/contents/nausea-and-vomiting-of-pregnancy-treatment-andoutcome#H21389680 (дата обращения — 15.04.2025).Smith J.A., Fox K.A., Clark S.M. Nausea and vomiting of pregnancy: treatment and outcome. UptoDate 2023. URL: https://www.uptodate.com/contents/nausea-and-vomiting-of-pregnancy-treatment-andoutcome#H21389680 (дата обращения — 15.04.2025).Figueroa Gray M., Hsu C., Kiel L., Dublin S. Getting through the day: a pilot qualitative study of U.S. women’s experiences making decisions about anti-nausea medication during pregnancy. BMC Pregnancy Childbirth. 2018;18(1):475. DOI: 10.1186/s12884-018-2093-6Figueroa Gray M., Hsu C., Kiel L., Dublin S. Getting through the day: a pilot qualitative study of U.S. women’s experiences making decisions about anti-nausea medication during pregnancy. BMC Pregnancy Childbirth. 2018;18(1):475. DOI: 10.1186/s12884-018-2093-6Widnes S.F., Schjøtt J. Risk perception regarding drug use in pregnancy. Am. J. Obstet. Gynecol. 2017;216(4):375–8. DOI: 10.1016/j.ajog.2016.12.007Widnes S.F., Schjøtt J. Risk perception regarding drug use in pregnancy. Am. J. Obstet. Gynecol. 2017;216(4):375–8. DOI: 10.1016/j.ajog.2016.12.007Monograph U. Use of ondansetron in pregnancy. 2019.Monograph U. Use of ondansetron in pregnancy. 2019.Jennings L.K., Mahdy H. Hyperemesis gravidarum [Internet]. StatPearls. 2022.Jennings L.K., Mahdy H. Hyperemesis gravidarum [Internet]. StatPearls. 2022.Pacei F., Tesone A., Laudi N., Laudi E. et al. The relevance of thiamine evaluation in a practical setting. Nutrients. 2020;12(9):2810. DOI: 10.3390/nu12092810Pacei F., Tesone A., Laudi N., Laudi E. et al. The relevance of thiamine evaluation in a practical setting. Nutrients. 2020;12(9):2810. DOI: 10.3390/nu12092810Hayakawa S., Nakajima N., Karasaki-Suzuki M., Yoshinaga H. et al. Frequent presence of helicobacter pylori genome in the saliva of patients with hyperemesis gravidarum. Am. J. Perinatol. 2000;17(5):243–8. DOI: 10.1055/s-2000-10005Hayakawa S., Nakajima N., Karasaki-Suzuki M., Yoshinaga H. et al. Frequent presence of helicobacter pylori genome in the saliva of patients with hyperemesis gravidarum. Am. J. Perinatol. 2000;17(5):243–8. DOI: 10.1055/s-2000-10005Niemeijer M.N., Grooten I.J., Vos N., Bais J.M.J. et al. Diagnostic markers for hyperemesis gravidarum: a systematic review and metaanalysis. Am. J. Obstet. Gynecol. 2014;211(2):150.e1–15. DOI: 10.1016/j.ajog.2014.02.012Niemeijer M.N., Grooten I.J., Vos N., Bais J.M.J. et al. Diagnostic markers for hyperemesis gravidarum: a systematic review and metaanalysis. Am. J. Obstet. Gynecol. 2014;211(2):150.e1–15. DOI: 10.1016/j.ajog.2014.02.012Regan L.A., Hoffman R.S., Nelson L.S. Slower infusion of metoclopramide decreases the rate of akathisia. Am. J. Emerg. Med. 2009;27(4):475– 80. DOI: 10.1016/j.ajem.2008.03.044Regan L.A., Hoffman R.S., Nelson L.S. Slower infusion of metoclopramide decreases the rate of akathisia. Am. J. Emerg. Med. 2009;27(4):475– 80. DOI: 10.1016/j.ajem.2008.03.044Boelig R.C., Barton S.J., Saccone G., Kelly A.J. et al. Interventions for treating hyperemesis gravidarum: a Cochrane systematic review and meta-analysis. J. Matern. Fetal Neonatal Med. 2018;31(18):2492–505. DOI: 10.1080/14767058.2017.1342805Boelig R.C., Barton S.J., Saccone G., Kelly A.J. et al. Interventions for treating hyperemesis gravidarum: a Cochrane systematic review and meta-analysis. J. Matern. Fetal Neonatal Med. 2018;31(18):2492–505. DOI: 10.1080/14767058.2017.1342805Grooten I.J., Vinke M.E., Roseboom T.J., Painter R.C. A systematic review and meta-analysis of the utility of corticosteroids in the treatment of hyperemesis gravidarum. Nutr. Metab. Insights. 2015;8(suppl.1):23– 32. DOI: 10.4137/NMI.S29532Grooten I.J., Vinke M.E., Roseboom T.J., Painter R.C. A systematic review and meta-analysis of the utility of corticosteroids in the treatment of hyperemesis gravidarum. Nutr. Metab. Insights. 2015;8(suppl.1):23– 32. DOI: 10.4137/NMI.S29532O’Brien B., Relyea M.J. Use of indigenous explanations and remedies to further understand nausea and vomiting during pregnancy. Health Care Women Int. 1999;20(1):49–61. DOI: 10.1080/073993399245953O’Brien B., Relyea M.J. Use of indigenous explanations and remedies to further understand nausea and vomiting during pregnancy. Health Care Women Int. 1999;20(1):49–61. DOI: 10.1080/073993399245953Bustos M., Venkataramanan R., Caritis S. Nausea and vomiting of pregnancy — what’s new? Auton. Neurosci. 2017;202:62–72. DOI: 10.1016/j.autneu.2016.05.002Bustos M., Venkataramanan R., Caritis S. Nausea and vomiting of pregnancy — what’s new? Auton. Neurosci. 2017;202:62–72. DOI: 10.1016/j.autneu.2016.05.002Basirat Z., Moghadamnia A.A., Kashifard M., Sarifi-Razavi A. The effect of ginger biscuit on nausea and vomiting in early pregnancy. Acta Med. Iran. 2009;47(1):51–6.Basirat Z., Moghadamnia A.A., Kashifard M., Sarifi-Razavi A. The effect of ginger biscuit on nausea and vomiting in early pregnancy. Acta Med. Iran. 2009;47(1):51–6.Vandraas K.F., Vikanes A.V., Vangen S., Magnus P. et al. Hyperemesis gravidarum and birth outcomes-a population-based cohort study of 2.2 million births in the Norwegian Birth Registry. BJOG. 2013;120(13):1654–60. DOI: 10.1111/1471-0528.12429Vandraas K.F., Vikanes A.V., Vangen S., Magnus P. et al. Hyperemesis gravidarum and birth outcomes-a population-based cohort study of 2.2 million births in the Norwegian Birth Registry. BJOG. 2013;120(13):1654–60. DOI: 10.1111/1471-0528.12429Koch K.L. Gastrointestinal factors in nausea and vomiting of pregnancy. Am. J. Obstet. Gynecol. 2002;186(5 suppl. understanding):S198–203. DOI: 10.1067/mob.2002.122598Koch K.L. Gastrointestinal factors in nausea and vomiting of pregnancy. Am. J. Obstet. Gynecol. 2002;186(5 suppl. understanding):S198–203. DOI: 10.1067/mob.2002.122598Nijsten K., Dean C., van der Minnen L.M., Bais J.M.J. et al. Recurrence, postponing pregnancy, and termination rates after hyperemesis gravidarum: follow up of the MOTHER study. Acta Obstet. Gynecol. Scand. 2021;100(9):1636–43. DOI: 10.1111/aogs.14197Nijsten K., Dean C., van der Minnen L.M., Bais J.M.J. et al. Recurrence, postponing pregnancy, and termination rates after hyperemesis gravidarum: follow up of the MOTHER study. Acta Obstet. Gynecol. Scand. 2021;100(9):1636–43. DOI: 10.1111/aogs.14197O’Hara M. Experience of hyperemesis gravidarum in a subsequent pregnancy. MIDIRS Midwifery Digest. 2017;27:309–18.O’Hara M. Experience of hyperemesis gravidarum in a subsequent pregnancy. MIDIRS Midwifery Digest. 2017;27:309–18.Sanghvi U., Thankappan K.R., Sarma P.S., Sali N. Assessing potential risk factors for child malnutrition in rural Kerala, India. J. Trop. Pediatr. 2001;47(6):350–5. DOI: 10.1093/tropej/47.6.350Sanghvi U., Thankappan K.R., Sarma P.S., Sali N. Assessing potential risk factors for child malnutrition in rural Kerala, India. J. Trop. Pediatr. 2001;47(6):350–5. DOI: 10.1093/tropej/47.6.350Liu S., Rouleau J., Joseph K.S., Sauve R. et al. Epidemiology of pregnancy-associated venous thromboembolism: a population-based study in Canada. J. Obstet. Gynaecol. Can. 2009;31(7):611–20. DOI: 10.1016/S1701-2163(16)34240-2Liu S., Rouleau J., Joseph K.S., Sauve R. et al. Epidemiology of pregnancy-associated venous thromboembolism: a population-based study in Canada. J. Obstet. Gynaecol. Can. 2009;31(7):611–20. DOI: 10.1016/S1701-2163(16)34240-2Pope E., Maltepe C., Koren G. Comparing pyridoxine and doxylamine succinate-pyridoxine HCl for nausea and vomiting of pregnancy: a matched, controlled cohort study. J. Clin. Pharmacol. 2015;55(7):809– 14. DOI: 10.1002/jcph.480Pope E., Maltepe C., Koren G. Comparing pyridoxine and doxylamine succinate-pyridoxine HCl for nausea and vomiting of pregnancy: a matched, controlled cohort study. J. Clin. Pharmacol. 2015;55(7):809– 14. DOI: 10.1002/jcph.480Doxylamine/pyridoxine for nausea and vomiting in pregnancy. Drug Ther. Bull. 2019;57(3):38–41. DOI: 10.1136/dtb.2018.000053Doxylamine/pyridoxine for nausea and vomiting in pregnancy. Drug Ther. Bull. 2019;57(3):38–41. DOI: 10.1136/dtb.2018.000053Шохин И.Е., Носков С.М., Глобенко А.А., Багаева Н.С. и др. Исследование фармакокинетических параметров и безопасности лекарственного препарата Дуоника после приема пищи в сравнении с оригинальной комбинацией доксиламина и пиридоксина. Фармакокинетика и фармакодинамика. 2024;2:3–11. DOI: 10.37489/2587-7836-2024-2-3-11Shohin I.E., Noskov S.M., Globenko A.A., Bagaeva N.S. et al. Study of pharmacokinetic parameters and safety of the drug Duonica in comparison with the original combination of doxylamine and pyridoxine under fed conditions. Pharmacokinetics and Pharmacodynamics. 2024;2:3–11. (in Russian). DOI: 10.37489/2587-7836-2024-2-3-11

The authors declare that there are no conflicts of interest present.