妊娠劇吐

妊娠劇吐
同义词	Hyperemesis gravidarum
症状	hyperemesis[*]
类型	妊娠併發症、孕吐
分类和外部资源
醫學專科	婦科學
ICD-11	JA60
ICD-10	O21.1
ICD-9-CM	643.1
DiseasesDB	6227
MedlinePlus	001499
eMedicine	254751
	[编辑此条目的维基数据]

妊娠劇吐（Hyperemesis gravidarum，HG）是妊娠併發症的一種。其特徵為足以造成體重下降與脫水的嚴重噁心和嘔吐^[1]。徵象和症狀包含一天內多次的劇吐還有暈眩感，其嚴重程度超越害喜。症狀通常會在懷孕二十週後稍微改善，但也可能整個懷孕期間都為此而苦^[2]。

造成妊娠劇吐的原因尚未確定^[3]，但已知的危險因子有初次懷孕、多胞胎、肥胖症、妊娠滋養層細胞疾病、進食障礙病史，或是先前曾發生或有妊娠劇吐的家族病史^[3]^[4]。本病通常根據其症狀確診。妊娠劇吐已經在實務上被定義為每日嘔吐超過三次、體重下降百分之五或三公斤、及在尿液中出現酮類^[3]。確診前應排除泌尿道感染與甲狀腺功能亢進等可能造成相似症狀的疾病^[5]。

本病療法包括補充流質、攝取清淡食物^[2]。建議包括服用電解質補充飲料（英语：electrolyte-replacement drinks）、硫胺、還有高蛋白質食品^[3]^[6]。有一些女性需要通過靜脈注射補充電解質及營養素^[2]。藥物治療方面，建議使用吡哆醇或是甲氧氯普胺^[5]，若無效則可用普樂明（英语：Prochlorperazine）、克暈片錠（英语：dimenhydrinate）、卓弗蘭治療^[5]^[3]。一些患者可能需要入院治療。其他替代療法如心理療法，以及傳統中醫則有對內關穴進行穴位按壓（英语：acupressure）的治療法可能具有療效^[3]^[7]。

關於懷孕時嘔吐的歷史紀錄，最早可以追溯到西元兩千年前，但直到1852年才由安托尼·杜布瓦（法语：Antoine Dubois）首度以醫學文獻的形式清楚描述妊娠劇吐^[8]。根據統計，妊娠劇吐影響0.3–2.0%懷孕女性，過去也曾經是懷孕婦女的常見死因，但現今因為完善的治療，其造成的死亡已經非常罕見^[9]^[10]^[11]。被妊娠劇吐影響的女性有較低的流產風險，但伴隨著較高的早產機率。某些女性會因為妊娠劇吐而選擇墮胎^[6]。

參考文獻编辑

^ Management of hyperemesis gravidarum.. Drug Ther Bull. 2013-11, 51 (11): 129–9. PMID 24227770. doi:10.1136/dtb.2013.11.0215.
^ ^2.0 ^2.1 ^2.2 Pregnancy. Office on Women's Health. September 27, 2010 [5 December 2015]. （原始内容存档于2015-12-10）.
^ ^3.0 ^3.1 ^3.2 ^3.3 ^3.4 ^3.5 Jueckstock, JK; Kaestner, R; Mylonas, I. Managing hyperemesis gravidarum: a multimodal challenge.. BMC medicine. 15 July 2010, 8: 46. PMID 20633258.
^ Ferri, Fred F. Ferri's clinical advisor 2013 5 books in 1 1st. St. Louis, Mo.: Elsevier Mosby. 2012: 538 [2016-02-02]. ISBN 9780323083737. （原始内容存档于2015-12-08）.
^ ^5.0 ^5.1 ^5.2 Sheehan, P. Hyperemesis gravidarum--assessment and management.. Australian family physician. September 2007, 36 (9): 698–701. PMID 17885701.
^ ^6.0 ^6.1 Gabbe, Steven G. Obstetrics : normal and problem pregnancies 6th. Philadelphia, PA: Elsevier/Saunders. 2012: 117 [2016-02-02]. ISBN 9781437719352. （原始内容存档于2015-12-08）.
^ Habek, D.; Barbir, A.; Habek, J. C.; Janculiak, D.; Bobić-Vuković, M. Success of acupuncture and acupressure of the Pc 6 acupoint in the treatment of hyperemesis gravidarum. Forschende Komplementärmedizin Und Klassische Naturheilkunde = Research in Complementary and Natural Classical Medicine. 2004-02-01, 11 (1): 20–23 [2016-02-02]. ISSN 1424-7364. PMID 15004444. doi:10.1159/000077192. （原始内容存档于2016-05-31）.
^ Davis, Christopher J. Nausea and Vomiting : Mechanisms and Treatment. Berlin, Heidelberg: Springer Berlin Heidelberg. 1986: 152 [2016-02-02]. ISBN 9783642704796. （原始内容存档于2015-12-08）.
^ Goodwin, TM. Hyperemesis gravidarum.. Obstetrics and gynecology clinics of North America. September 2008, 35 (3): 401–17, viii. PMID 18760227. doi:10.1016/j.ogc.2008.04.002.
^ Kumar, Geeta. Early Pregnancy Issues for the MRCOG and Beyond. Cambridge University Press. 2011: Chapter 6 [2016-02-02]. ISBN 9781107717992. （原始内容存档于2015-12-08）.
^ DeLegge, Mark H. Handbook of home nutrition support. Sudbury, Mass.: Jones and Bartlett. 2007: 320 [2016-02-02]. ISBN 9780763747695. （原始内容存档于2015-12-08）.

外部連結编辑

[Drug2013-1] Management of hyperemesis gravidarum.. Drug Ther Bull. 2013-11, 51 (11): 129–9. PMID 24227770. doi:10.1136/dtb.2013.11.0215.

[Women2010-2] 2.0 ^2.1 ^2.2 Pregnancy. Office on Women's Health. September 27, 2010 [5 December 2015]. （原始内容存档于2015-12-10）.

[BMC2010-3] 3.0 ^3.1 ^3.2 ^3.3 ^3.4 ^3.5 Jueckstock, JK; Kaestner, R; Mylonas, I. Managing hyperemesis gravidarum: a multimodal challenge.. BMC medicine. 15 July 2010, 8: 46. PMID 20633258.

[Fer2013-4] Ferri, Fred F. Ferri's clinical advisor 2013 5 books in 1 1st. St. Louis, Mo.: Elsevier Mosby. 2012: 538 [2016-02-02]. ISBN 9780323083737. （原始内容存档于2015-12-08）.

[AFP2007-5] 5.0 ^5.1 ^5.2 Sheehan, P. Hyperemesis gravidarum--assessment and management.. Australian family physician. September 2007, 36 (9): 698–701. PMID 17885701.

[Gab2012-6] 6.0 ^6.1 Gabbe, Steven G. Obstetrics : normal and problem pregnancies 6th. Philadelphia, PA: Elsevier/Saunders. 2012: 117 [2016-02-02]. ISBN 9781437719352. （原始内容存档于2015-12-08）.

[7] Habek, D.; Barbir, A.; Habek, J. C.; Janculiak, D.; Bobić-Vuković, M. Success of acupuncture and acupressure of the Pc 6 acupoint in the treatment of hyperemesis gravidarum. Forschende Komplementärmedizin Und Klassische Naturheilkunde = Research in Complementary and Natural Classical Medicine. 2004-02-01, 11 (1): 20–23 [2016-02-02]. ISSN 1424-7364. PMID 15004444. doi:10.1159/000077192. （原始内容存档于2016-05-31）.

[8] Davis, Christopher J. Nausea and Vomiting : Mechanisms and Treatment. Berlin, Heidelberg: Springer Berlin Heidelberg. 1986: 152 [2016-02-02]. ISBN 9783642704796. （原始内容存档于2015-12-08）.

[Goodwin2008-9] Goodwin, TM. Hyperemesis gravidarum.. Obstetrics and gynecology clinics of North America. September 2008, 35 (3): 401–17, viii. PMID 18760227. doi:10.1016/j.ogc.2008.04.002.

[10] Kumar, Geeta. Early Pregnancy Issues for the MRCOG and Beyond. Cambridge University Press. 2011: Chapter 6 [2016-02-02]. ISBN 9781107717992. （原始内容存档于2015-12-08）.

[11] DeLegge, Mark H. Handbook of home nutrition support. Sudbury, Mass.: Jones and Bartlett. 2007: 320 [2016-02-02]. ISBN 9780763747695. （原始内容存档于2015-12-08）.

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