Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-two women with hyperemesis gravidarum were treated with intramuscular ACTH (0.5 mg) or placebo for 4 days in a randomized double-blind trial. The two treatments were equally effective in relieving hyperemesis, although the function of the adrenal cortex was stimulated only during the ACTH therapy. The administration of ACTH thus appears useless for the treatment of severe vomiting in early pregnancy.
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PMID:Intramuscular ACTH or placebo in the treatment of hyperemesis gravidarum. 23 74

Biochemical evidence of hyperthyroidism is frequently encountered in hyperemesis gravidarum, but its relationship to the cause of hyperemesis is unknown. We studied the relationship of serum hCG, thyroid function, and severity of vomiting among 57 hyperemesis patients and 57 controls matched for gestational age. TSH was suppressed in 60% of hyperemesis patients and 9% of controls. hCG correlated directly with free T4(r = 0.45, P < 0.001) and inversely with TSH (r = -0.48, P < 0.001). Hyperemesis patients had significantly greater mean serum hCG, free T4, total T3, and estradiol, and lesser serum TSH compared to controls. Hyperemesis patients with suppressed TSH had significantly greater free T4 and hCG compared to those with TSH in the normal range. Control and hyperemesis subjects were divided into four groups based on the severity of vomiting. The degree of biochemical hyperthyroidism and hCG concentration varied directly with the severity of vomiting. Unextracted serum was tested for thyrotropic activity by measuring its effect on iodide uptake in cultured FRTL-5 rat thyroid cells. Thyrotropic activity correlated with serum hCG (r = 0.50, P < 0.001). These data show that biochemical hyperthyroidism is a common finding in patients with hyperemesis gravidarum and suggest that hCG is the thyroid stimulator in this state. The increased estradiol concentration in patients with hyperemesis gravidarum may be attributed to the effects of hCG on steroidogenesis.
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PMID:The role of chorionic gonadotropin in transient hyperthyroidism of hyperemesis gravidarum. 143 95

Although now there is no doubt about the role of psychosocial factors in hyperemesis gravidarum, remarkably little literature can be found on the subject of psychotherapy and hyperemesis. This may be due to the decreasing number of severe cases, light cases generally do not require treatment. In the past, mostly hypnosis and several different types of supportive psychotherapy were propagated. We are reporting about the trial attempt of treating a patient with hyperemesis gravidarum with in-patient psychotherapy on an internal medicine-psychosomatics ward in tight cooperation with the referring gynaecological clinic. We suggest in-patient psychotherapy as one possibility of treating protracted vomiting in pregnancy.
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PMID:[Inpatient psychotherapy of hyperemesis gravidarum--a case report]. 149 49

Psychosocial factors have long been believed to be important in the pathogenesis of emesis gravidarum (morning sickness) and hyperemesis gravidarum (HG). Although this has been confirmed during extensive studies over the last 30 years, HG has never been described as a conversion reaction. We describe two women presenting with hyperemesis who clearly fulfill diagnostic criteria for conversion. We suggest that strong psychodynamic conflicts are expressed by this potentially dangerous symptom in a subset of individuals and that dynamic interventions have a role in treating certain patients with HG.
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PMID:Hyperemesis gravidarum as conversion disorder. 223 Jul 51

A male patient with hyperemesis as a result of hyperthyroidism was presented. Investigations for causes were negative except for hyperthyroxinaemia. Treatment with antithyroid drug relieved the symptom. Hyperemesis associated with hyperthyroidism occurs predominantly in females. A likely emetic factor oestrogen. Hyperthyroidism could have potentiated this effect. Levels of oestrogens are raised in thyrotoxicosis. The hyperthyroidism, the raised oestrogens and a low emetic threshold conspired to hyperemesis in this patient, a situation not unlike hyperemesis gravidarum. Thyrotoxic vomiting once recognised is readily by antithyroid treatment.
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PMID:Thyrotoxic hyperemesis: a case report. 261 5

Twenty-five patients with severe persistent vomiting were studied. On admission they were given the diagnosis of hyperemesis gravidarum. Hyperemesis was defined as vomiting of sufficient severity to warrant admission to hospital and iv therapy, which was not associated with any other condition known to cause vomiting other than the pregnancy itself. Ten (40%) of the patients had free thyroxine levels which were elevated on admission with hyperemesis. The free thyroxine normalised when the patients were well but still pregnant and remained normal post partum. Longitudinal data for nine other thyroid parameters are given and all illustrate the transient nature of the disturbed function in hyperemesis gravidarum.
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PMID:Thyroid function in hyperemesis gravidarum. 308 27

Two studies were conducted to assess factors associated with increased risk of hyperemesis gravidarum during pregnancy with data and serum samples collected from participants in the Collaborative Perinatal Study. In the case-control study, 419 pregnant women with hyperemesis gravidarum were matched on medical center, date of study registration, and race with 836 pregnant women who did not vomit during the index pregnancy. Younger age, nulliparity, and high body weight were significantly associated with increased risk of hyperemesis. Women with hyperemesis had significantly reduced risk of fetal loss; however, their infants had higher risk of central nervous system malformations. In the second study, first-trimester pregnancy hormones were measured in the serum of 35 women with hyperemesis and 35 control women who were individually matched to cases on age, parity, and medical center. After adjusting for length of gestation, mean levels of total estradiol were 26% higher and mean levels of sex hormone binding-globulin binding capacity were 37% higher in patients with hyperemesis gravidarum than in control subjects. These differences were statistically significant. Although human chorionic gonadotropin concentrations were higher in control pregnancies, the differences were not statistically significant. The average amount of estradiol that was nonprotein bound (adjusted for length of gestation) was also higher in patients than in control subjects. These results are consistent with the hypothesis that elevated estrogen levels are responsible for excessive vomiting in pregnancy.
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PMID:Hyperemesis gravidarum in relation to estradiol levels, pregnancy outcome, and other maternal factors: a seroepidemiologic study. 357 25

Factors associated with early pregnancy vomiting were investigated in 9098 first-trimester registrants in the Collaborative Perinatal Project. Vomiting in the absence of hyperemesis or gastroenteritis was noted in 56% of all women, and was more common among primigravidas (P = .002), younger women (P less than .001), women with less than 12 years of education (P less than .001), nonsmokers (P less than .001), and women weighing 77.1 kg (170 lb) or more (P = .003). Adjustment for confounders did not change these associations. Women reporting vomiting were less likely to experience miscarriage or stillbirth (P = .002) and delivery before 37 weeks' gestation (P = .004), but there was no difference in infant birth weight between mothers with and without vomiting (P = .48). Women who vomit in one pregnancy are more likely to vomit in subsequent pregnancies than are comparable women who did not vomit.
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PMID:Epidemiology of vomiting in early pregnancy. 390 78

The patient was a 37-year-old female teacher with hyperemesis diabeticorum and juvenile Type-I diabetes. At the age of 29 years, nausea and vomiting developed and secured at nearly weekly intervals. She was started on clotiazepam (15 mg/day). The vomiting was cured and psychological improvement was evident; her anxiety about diabetes was markedly reduced. An X-ray examination after the administration of clotiazepam showed that she was entirely free from marked hypoperistalsis and the severe retention of gastric contents which had been present before this treatment. The present case is a clear example of stress closely related to the pathogenesis of hyperemesis diabeticorum.
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PMID:Influence of an antianxiety drug on hyperemesis diabeticorum. 612 62

Splenic avulsion in pregnancy is a rare condition that carries a high risk of death to both mother and fetus. The authors describe a 30-year-old woman with hyperemesis who had spontaneous avulsion of the spleen at 30 weeks' gestation. She underwent a splenectomy and cesarean section, resulting in a stillborn fetus. The authors theorize that violent vomiting resulted in splenic avulsion. Prompt surgical intervention by a general surgeon and obstetrician is required in such cases.
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PMID:Splenic avulsion in a pregnant patient with vomiting. 755 74


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