Alternative Methods of Therapy of Nausea and Vomiting of Pregnant Women
https://doi.org/10.31550/1727-2378-2022-21-5-25-30
Abstract
Study Objective: Evaluation of the effectiveness of ginger extract in the treatment of nausea and vomiting light and moderate range of pregnant women.
Study Design: Observational study.
Materials and Methods. The research included 56 pregnant women with symptoms of nausea and vomiting: at the first visit they had complaints of nausea and/or vomiting being 6–16 weeks pregnant. The severity of nausea and vomiting was assessed on the Pregnancy-Unique Quantification of Emesis and Nausea scale before the start of therapy, on days 4 and 7 of treatment. The pregnant women were divided into two groups. The main group consisted of 28 women who took the dietary supplement Preginor, a comparison group — 28 patients who were given only recommendations for lifestyle and diet modification. Among 56 pregnant women who were studied, there 36 were with light symptoms of nausea and vomiting (18 women from the main group and 18 in the comparison group); 20 pregnant women had a moderate degree of nausea and vomiting (10 patients from the main group, 10 from the comparison group). Preginor contains a highly selective ginger root extract (67 mg) standardized to 5% gingerols, which corresponds to about 1 g of fresh ginger; vitamin B6 1.4 mg, magnesium lactate 112.5 mg.
Study Results. Relief of symptoms of nausea and vomiting in pregnant women who took ginger was on average 48 hours faster compared to patients who received only recommendations for lifestyle and diet modification: after 3,3 (0,5) and 5,1 (1,2) days, respectively (t = –5,60, p = 0.000). With a moderate course of nausea and vomiting, taking ginger also helped to alleviate the condition in the majority of patients (80%).
Conclusion. Preginor is an effective non-pharmacological remedy for the relief of symptoms of nausea and vomiting of pregnant women. It is advisable to recommend the dietary supplement Preginor for widespread introduction into clinical practice, raising the awareness of medical personnel and patients about its effectiveness and safety.
About the Authors
M. E. Zhelezova
Federal State Educational Institution of Higher Education “Kazan (Volga region) Federal University”
Russian Federation
Russian Federation
74 Karl Marks Str., Kazan, 420012
R. I. Sharipova
Federal State Educational Institution of Higher Education “Kazan (Volga region) Federal University”
Russian Federation
Russian Federation
74 Karl Marks Str., Kazan, 420012
References
1. Einarson T.R., Piwko C., Koren G. Quantifying the global rates of nausea and vomiting of pregnancy: a meta analysis. J. Popul. Ther. Clin. Pharmacol. 2013; 20(2): e171–83.
2. Jansen 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.2021.09.004
3. Erdal H., Holst L., Heitmann K., Trovik J. Antiemetic treatment of hyperemesis gravidarum in 1,064 Norwegian women and the impact of European warning on metoclopramide: a retrospective cohort study 2002–2019. BMC Pregnancy Childbirth. 2022; 22(1): 464. DOI: 10.1186/s12884-022-04777-x
4. Koch K.L., Frissora C.L. Nausea and vomiting during pregnancy. Gastroenterol. Clin. North Am. 2003; 32(1): 201–34, vi. DOI: 10.1016/s0889-8553(02)00070-5
5. Lee N.M., Saha S. Nausea and vomiting of pregnancy. Gastroenterol. Clin. North Am. 2011; 40(2): 309–34, vii. DOI: 10.1016/j.gtc.2011.03.009
6. Fiaschi 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.12416
7. Fejzo M.S., Trovik J., Grooten I.J., Sridharan K. et al. Nausea and vomiting of pregnancy and hyperemesis gravidarum. Nat. Rev. Dis. Primers. 2019; 5(1): 62. DOI: 10.1038/s41572-019-0110-3
8. Nana M., Tydeman F., Bevan G., Boulding H. et al. Hyperemesis gravidarum is associated with increased rates of termination of pregnancy and suicidal ideation: results from a survey completed by > 5000 participants. Am. J. Obstet. Gynecol. 2021; 224(6): 629–31. DOI: 10.1016/j.ajog.2021.03.006
9. Dean C.R., Bruin C.M., O’Hara M.E., Roseboom T.J. et al. The chance of recurrence of hyperemesis gravidarum: a systematic review. Eur. J. Obstet. Gynecol. Reprod. Biol. X. 2020; 5: 100105. DOI: 10.1016/j.eurox.2019.100105
10. Nijsten K., Dean C., van der Minnen L.M., Bais J.M. 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.14197
11. Bustos M., Venkataramanan R., Caritis S. Nausea and vomiting of pregnancy — what's new? Auton. Neurosci. 2017; 202: 62–72. DOI: 10.1016/j.autneu.2016.05.002
12. Zhang Y., Cantor R.M., MacGibbon K., Romero R. et al. Familial aggregation of hyperemesis gravidarum. Am. J. Obstet. Gynecol. 2011; 204(3): 230.e1–7. DOI: 10.1016/j.ajog.2010.09.018
13. Niebyl J.R. Clinical practice. Nausea and vomiting in pregnancy. N. Engl. J. Med. 2010; 363(16): 1544–50. DOI: 10.1056/NEJMcp1003896
14. Goodwin T.M. Hyperemesis gravidarum. Obstet. Gynecol. Clin. North Am. 2008; 35(3): 401–17, viii. DOI: 10.1016/j.ogc.2008.04.002
15. Golberg D., Szilagyi A., Graves L. Hyperemesis gravidarum and Helicobacter pylori infection: a systematic review. Obstet. Gynecol. 2007; 110(3): 695–703. DOI: 10.1097/01.AOG.0000278571.93861.26
16. Shaban M.M., Kandil H.O., Elshafei A.H. Helicobacter pylori seropositivity in patients with hyperemesis gravidarum. Am. J. Med. Sci. 2014; 347(2): 101–5. DOI: 10.1097/MAJ.0b013e31827bef91
17. Grooten I.J., Mol B.W., van der Post J.A.M., Ris-Stalpers C. et al. Early nasogastric tube feeding in optimising treatment for hyperemesis gravidarum: the MOTHER randomised controlled trial (Maternal and Offspring outcomes after Treatment of HyperEmesis by Refeeding). BMC Pregnancy Childbirth. 2016; 16: 22. DOI: 10.1186/s12884-016-0815-1
18. Bischoff S.C., Renzer C. Nausea and nutrition. Auton. Neurosci. 2006; 129(1–2): 22–7. DOI: 10.1016/j.autneu.2006.07.011
19. Jueckstock J.K., Kaestner R., Mylonas I. Managing hyperemesis gravidarum: a multimodal challenge. BMC Med. 2010; 8: 46. DOI: 10.1186/1741-7015-8-46
20. Sechi G., Serra A. Wernicke's encephalopathy: new clinical settings and recent advances in diagnosis and management. Lancet Neurol. 2007; 6(5): 442–55. DOI: 10.1016/S1474-4422(07)70104-7
21. Chiossi G., Neri I., Cavazzuti M., Basso G. et al. Hyperemesis gravidarum complicated by Wernicke encephalopathy: background, case report, and review of the literature. Obstet. Gynecol. Surv. 2006; 61(4): 255–68. DOI: 10.1097/01.ogx.0000206336.08794.65
22. Berdai M.A., Labib S., Harandou M. Wernicke's encephalopathy complicating hyperemesis during pregnancy. Case Rep. Crit. Care. 2016; 2016: 8783932. DOI: 10.1155/2016/8783932
23. American College of Obstetrics and Gynecology. ACOG (American College of Obstetrics and Gynecology) Practice Bulletin: nausea and vomiting of pregnancy. Obstet. Gynecol. 2004; 103(4): 803–14.
24. Viljoen E., Visser J., Koen N., Musekiwa A. A systematic review and meta-analysis of the effect and safety of ginger in the treatment of pregnancy-associated nausea and vomiting. Nutr. J. 2014; 13: 20. DOI: 10.1186/1475-2891-13-20
25. Haniadka R., Saldanha E., Sunita V., Palatty P.L. et al. A review of the gastroprotective effects of ginger (Zingiber officinale Roscoe). Food Funct. 2013; 4(6): 845–55. DOI: 10.1039/c3fo30337c
26. Hu M.L., Rayner C.K., Wu K.L., Chuah S.K. et al. Effect of ginger on gastric motility and symptoms of functional dyspepsia. World J. Gastroenterol. 2011; 17(1): 105–10. DOI: 10.3748/wjg.v17.i1.105
27. Pertz H.H., Lehmann J., Roth-Ehrang R., Elz S. Effects of ginger constituents on the gastrointestinal tract: role of cholinergic M3 and serotonergic 5-HT3 and 5-HT4 receptors. Planta Med. 2011; 77(10): 973–8. DOI: 10.1055/s-0030-1270747
28. Vutyavanich T., Kraisarin T., Ruangsri R. Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial. Obstet. Gynecol. 2001; 97(4): 577–82. DOI: 10.1016/s0029-7844(00)01228-x
29. Portnoi G., Chng L.A., Karimi-Tabesh L., Koren G. et al. Prospective comparative study of the safety and effectiveness of ginger for the treatment of nausea and vomiting in pregnancy. Am. J. Obstet. Gynecol. 2003; 189(5): 1374–7. DOI: 10.1067/s0002-9378(03)00649-5
30. Stanisiere J., Mousset P.Y., Lafay S. How safe is ginger rhizome for decreasing nausea and vomiting in women during early pregnancy? Foods. 2018; 7(4): 50. DOI: 10.3390/foods7040050
31. Gilboa S.M., Ailes E.C., Rai R.P., Anderson J.A. et al. Antihistamines and birth defects: a systematic review of the literature. Expert Opin. Drug Saf. 2014; 13(12): 1667–98. DOI: 10.1517/14740338.2014.970164
32. Tan P.C., Khine P.P., Vallikkannu N., Omar S.Z. Promethazine compared with metoclopramide for hyperemesis gravidarum: a randomized controlled trial. Obstet. Gynecol. 2010; 115(5): 975–81. DOI: 10.1097/AOG.0b013e3181d99290
33. Matok I., Gorodischer R., Koren G., Sheiner E. et al. The safety of metoclopramide use in the first trimester of pregnancy. N. Engl. J. Med. 2009; 360(24): 2528–35. DOI: 10.1056/NEJMoa0807154
34. Sanu O., Lamont R.F. Hyperemesis gravidarum: pathogenesis and the use of antiemetic agents. Expert Opin. Pharmacother. 2011; 12(5): 737–48. DOI: 10.1517/14656566.2010.537655
35. Badell M.L., Ramin S.M., Smith J.A. Treatment options for nausea and vomiting during pregnancy. Pharmacotherapy. 2006; 26(9): 1273–87. DOI: 10.1592/phco.26.9.1273
36. Einarson A., Maltepe C., Navioz Y., Kennedy D. et al. The safety of ondansetron for nausea and vomiting of pregnancy: a prospective comparative study. BJOG. 2004; 111(9): 940–3. DOI: 10.1111/j.1471-0528.2004.00236.x
37. Pasternak B., Svanström H., Hviid A. Ondansetron in pregnancy and risk of adverse fetal outcomes. N. Engl. J. Med. 2013; 368(9): 814–23. DOI: 10.1056/NEJMoa1211035
38. Carstairs S.D. Ondansetron use in pregnancy and birth defects: a systematic review. Obstet. Gynecol. 2016; 127(5): 878–83. DOI: 10.1097/AOG.0000000000001388
39. Danielsson B., Wikner B.N., Källén B. Use of ondansetron during pregnancy and congenital malformations in the infant. Reprod. Toxicol. 2014; 50: 134–7. DOI: 10.1016/j.reprotox.2014.10.017
40. Law R., Maltepe C., Bozzo P., Einarson A. Treatment of heartburn and acid reflux associated with nausea and vomiting during pregnancy. Can. Fam. Physician. 2010; 56(2): 143–4.
41. Gill S.K., Maltepe C., Koren G. The effect of heartburn and acid reflux on the severity of nausea and vomiting of pregnancy. Can. J. Gastroenterol. 2009; 23(4): 270–2. DOI: 10.1155/2009/678514
42. Zielinski R., Searing K., Deibel M. Gastrointestinal distress in pregnancy: prevalence, assessment, and treatment of 5 common minor discomforts. J. Perinat. Neonatal Nurs. 2015; 29(1): 23–31. DOI: 10.1097/JPN.0000000000000078
43. Nelson-Piercy C., Fayers P., de Swiet M. Randomised, double-blind, placebo-controlled trial of corticosteroids for the treatment of hyperemesis gravidarum. BJOG. 2001; 108(1): 9–15. DOI: 10.1111/j.1471-0528.2001.00017.x
44. Park-Wyllie L., Mazzotta P., Pastuszak A., Moretti M.E. et al. Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies. Teratology. 2000; 62(6): 385–92. DOI: 10.1002/1096-9926(200012)62:6<385::AID-TERA5>3.0.CO;2-Z
45. Pradat P., Robert-Gnansia E., Di Tanna G.L., Rosano A. et al. First trimester exposure to corticosteroids and oral clefts. Birth Defects Res. A Clin. Mol. Teratol. 2003; 67(12): 968–70. DOI: 10.1002/bdra.10134
46. Skuladottir H., Wilcox A.J., Ma C., Lammer E.J. et al. Corticosteroid use and risk of orofacial clefts. Birth Defects Res. A Clin. Mol. Teratol. 2014; 100(6): 499–506. DOI: 10.1002/bdra.23248
47. Parker S., Star J., Collet B., Speltz M.L. et al. Nausea and vomiting and neurodevelopment outcomes in offspring. J. Pediatr. Perinat. Epidemiol. 2014; 28(6): 527–35. DOI: 10.1111/ppe.12151
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Zhelezova M.E., Sharipova R.I. Alternative Methods of Therapy of Nausea and Vomiting of Pregnant Women. Title. 2022;21(5):25-30. (In Russ.) https://doi.org/10.31550/1727-2378-2022-21-5-25-30
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