BibTex RIS Kaynak Göster

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Yıl 2014, Cilt: 5 Sayı: 2, 72 - 76, 27.04.2014

Öz

Hyperemesis gravidarum, or pernicious vomiting of pregnancy, which can cause weight loss, electrolyte imbalance, kidney function disorders, is a complication of pregnancy that may have serious effects to the fetus. More than 80 % of pregnant women suffer from nausea and vomiting, however, hyperemesis gravidarum presents in only about 1 % to 3 %. It may have both maternal and fetal adverse effects. There are many treatment modalities such as, changing lifestyle, diet, non-pharmacologic agents, psychotherapy and antiemetics

Kaynakça

  • Broussard CN, Richter JE. Nausea and vomiting of preg- nancy. Gastroenterol Clin North Am. 1998; 27(1): 123-151.
  • Abell TL, Riely CA. Hyperemesis gravidarum. Gastroen- terol Clin North Am. 1992; 21(4): 835-849.
  • Tan PC, Khine PP, Vallikkannu N, Omar SZ. Prometha- zine compared with metoclopramide for hyperemesis grav- idarum: a randomized controlled trial. Obstet Gynecol. 2010; 115(5): 975-981.
  • Jueckstock JK, Kaestner R, Mylonas I. Managing hyper- emesis gravidarum: a multimodal challenge. BMC Med. 2010; 8: 46.
  • Goodwin TM. Hyperemesis gravidarum. Clin Obstet Gy- necol. 1998; 41(3): 597-605.
  • Simon EP, Schwartz J. Medical hypnosis for hyperemesis gravidarum. Birth. 1999; 26(4): 248-254.
  • Sonkusare S. Hyperemesis gravidarum: a review. Med J Malaysia. 2008; 63(3): 272-6; quiz 7.
  • Tan PC, Jacob R, Quek KF, Omar SZ. Pregnancy outcome in hyperemesis gravidarum and the effect of laboratory clin- ical indicators of hyperemesis severity. J Obstet Gynaecol Res. 2007; 33(4): 457-464.
  • Carlsson CP, Axemo P, Bodin A, Carstensen H, Ehren- roth B, Madegard-Lind I, Navander C. Manual acupuncture reduces hyperemesis gravidarum: a placebo-controlled, randomized, single-blind, crossover study. J Pain Symptom Manage. 2000; 20(4): 273-279.
  • Borgeat A, Fathi M, Valiton A. Hyperemesis gravidarum: is serotonin implicated? Am J Obstet Gynecol. 1997; 176(2): 476-4
  • Taylor R. Successful management of hyperemesis grav- idarum using steroid therapy. QJM. 1996; 89(2): 103-107.
  • Fischer-Rasmussen W, Kjaer SK, Dahl C, Asping U. Gin- ger treatment of hyperemesis gravidarum. Eur J Obstet Gy- necol Reprod Biol. 1991; 38(1): 19-24.
  • Eliakim R, Abulafia O, Sherer DM. Hyperemesis grav- idarum: a current review. Am J Perinatol. 2000; 17(4): 207- 2
  • Chong W, Johnston C. Unsuspected thyrotoxicosis and hyperemesis gravidarum in Asian women. Postgrad Med J. 1997; 73(858): 234-236.
  • Kuscu NK, Koyuncu F. Hyperemesis gravidarum: current concepts and management. Postgrad Med J. 2002; 78(916): 76
  • Poursharif B, Korst LM, Macgibbon KW, Fejzo MS, Romero R, Goodwin TM. Elective pregnancy termination in a large cohort of women with hyperemesis gravidarum. Con- traception. 2007; 76(6): 451-455.
  • Bailit JL. Hyperemesis gravidarium: Epidemiologic find- ings from a large cohort. Am J Obstet Gynecol. 2005; 193(3 Pt 1): 811-814.
  • Dodds L, Fell DB, Joseph KS, Allen VM, Butler B. Out- comes of pregnancies complicated by hyperemesis grav- idarum. Obstet Gynecol. 2006; 107: 285-292.
  • Veenendaal MV, van Abeelen AF, Painter RC, van der Post JA, Roseboom TJ. Consequences of hyperemesis grav- idarum for offspring: a systematic review and meta-analysis. BJOG. 2011; 118(11): 1302-1313.
  • 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.
  • Tsang IS, Katz VL, Wells SD. Maternal and fetal out- comes in hyperemesis gravidarum. Int J Gynaecol Obstet. 1996; 55(3): 231-235.
  • Ebrahimi N, Maltepe C, Bournissen FG, 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): 803-807.
  • Power Z, Campbell M, Kilcoyne P, Kitchener H, Waterman H. The Hyperemesis Impact of Symptoms Questionnaire: development and validation of a clinical tool. Int J Nurs Stud. 2010; 47(1): 67-77.
  • Lacasse A, Rey E, Ferreira E, Morin C, Berard A. 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): 71-77.
  • Ismail SK, Kenny L. Review on hyperemesis gravidarum. Best Pract Res Clin Gastroenterol. 2007; 21(5): 755-769.
  • Ozerkan K, Küçükkömürcü Ş, Özdil M, Arslan E, Saraydaroğlu Ö. Hiperemezis Gravidarum ve Mide Kanseri. Turkiye Klinikleri J Gynecol Obst . 2007; 17(3): 224-227.
  • Aslan E, Şimşek E, Kılıçdağ E, Bolat F, Nursal TZ, Haydardedeoğlu B. Hiperemezis gravidarum ayırıcı tanısında mide kanseri: Olgu sunumu. J Turk Soc Obstet Gynecol. 2008; 5(1): 36-39.
  • Jednak MA, Shadigian EM, Kim MS, Woods ML, Hooper FG, Owyang C, asler WL. Protein meals reduce nausea and gastric slow wave dysrhythmic activity in first trimester pregnancy. Am J Physiol. 1999; 277: 855-861.
  • Nelson-Piercy C. Treatment of nausea and vomiting in pregnancy. When should it be treated and what can be safely taken? Drug Saf. 1998; 19(2): 155-164.
  • Shrim A, Boskovic R, Maltepe C, Navios Y, Garcia- Bournissen F, Koren G. Pregnancy outcome following use of large doses of vitamin B6 in the first trimester. J Obstet Gynaecol. 2006; 26(8): 749-751.
  • Einarson A, Maltepe C, Boskovic R, Koren G. Treatment of nausea and vomiting in pregnancy: an updated algorithm. Can Fam Physician. 2007; 53(12): 2109-2111.
  • Hornby PJ. Central neurocircuitry associated with emesis. Am J Med. 2001; 111 Suppl 8A: 106S-112S.
  • Sheean PM, Braunschweig CA. Exploring the clinical characteristics of parenteral nutrition recipients admitted for initial hematopoietic stem cell transplantation. J Am Diet Assoc. 2007; 107(8): 1398-1403.
  • World MJ. Ondansetron and hyperemesis gravidarum. Lancet. 1993 16; 341(8838): 185.
  • Sullivan CA, Johnson CA, Roach H, Martin RW, Stewart DK, Morrison JC. A pilot study of intravenous ondansetron for hyperemesis gravidarum. Am J Obstet Gynecol. 1996; 174(5): 1565-1568.
  • Festin M. Nausea and vomiting in early pregnancy. Clin Evid (Online). 2009; 2009.
  • Mazzotta P, Magee LA. A risk-benefit assessment of pharmacological and nonpharmacological treatments for nausea and vomiting of pregnancy. Drugs. 2000; 59(4): 781- 800.
  • Tan PC, Omar SZ. Contemporary approaches to hyperemesis during pregnancy. Curr Opin Obstet Gynecol. 2011; 23(2): 87-93.
  • Ferreira E, Gillet M, Lelievre J, Bussieres JF. Ondansetron use during pregnancy: a case series. J Popul Ther Clin Pharmacol. 2012; 19(1): 1-10.
  • Einarson A, Maltepe C, Navioz Y, Kennedy D, Tan MP, Koren G. The safety of ondansetron for nausea and vomiting of pregnancy: a prospective comparative study. BJOG. 2004; 111(9): 940-943.
  • Asker C, Norstedt Wikner B, Kallen B. Use of antiemetic drugs during pregnancy in Sweden. Eur J Clin Pharmacol. 2005; 61(12): 899-906.
  • Tan PC, Yow CM, Omar SZ. A placebo-controlled trial of oral pyridoxine in hyperemesis gravidarum. Gynecol Obstet Invest. 2009; 67(3): 151-157.
  • Nageotte MP, Briggs GG, Towers CV, Asrat T. Droperidol and diphenhydramine in the management of hyperemesis gravidarum. Am J Obstet Gynecol. 1996; 174(6): 1801-1805; discussion 5-6.
  • Lacasse A, Lagoutte A, Ferreira E, Berard A. Metoclopramide and diphenhydramine in the treatment of hyperemesis gravidarum: effectiveness and predictors of rehospitalisation. Eur J Obstet Gynecol Reprod Biol. 2009; 143(1): 43-49.
  • Ditto A, Morgante G, la Marca A, De Leo V. Evaluation of treatment of hyperemesis gravidarum using parenteral fluid with or without diazepam. A randomized study. Gynecol Obstet Invest. 1999; 48(4): 232-236.
  • Reichmann JP, Kirkbride MS. Nausea and vomiting of pregnancy: cost effective pharmacologic treatments. Manag Care. 2008; 17(12): 41-45.
  • Tasci Y, Demir B, Dilbaz S, Haberal A. Use of diazepam for hyperemesis gravidarum. J Matern Fetal Neonatal Med. 2009; 22(4): 353-356.
  • Park-Wyllie L, Mazzotta P, Pastuszak A, Moretti ME, Beique L, Hunnisett L, Friesen MH, Jacobson S, Kasapi- novic S, Chang D, Diav-Citrin O, Chitayat D, Nulman I, Ein- arson TR, Koren G. Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies. Teratology. 2000; 62(6): 385-392.
  • Dolovich LR, Addis A, Vaillancourt JM, Power JD, Ko- ren G, Einarson TR. Benzodiazepine use in pregnancy and major malformations or oral cleft: meta-analysis of cohort and case-control studies. BMJ. 1998; 317(7162): 839-843.
  • Schwarzer V, Heep A, Gembruch U, Rohde A. Treatment resistant hyperemesis gravidarum in a patient with type 1 diabetes mellitus: neonatal withdrawal symptoms after suc- cessful antiemetic therapy with mirtazapine. Arch Gynecol Obstet. 2008; 277(1): 67-69.
  • Safari HR, Fassett MJ, Souter IC, Alsulyman OM, Good- win TM. The efficacy of methylprednisolone in the treatment of hyperemesis gravidarum: a randomized, double-blind, controlled study. Am J Obstet Gynecol. 1998; 179(4): 921- 9
  • Vutyavanich T, Kraisarin T, Ruangsri R. Ginger for nau- sea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial. Obstet Gynecol. 2001; 97(4): 577- 5
  • Hsu JJ, Clark-Glena R, Nelson DK, Kim CH. Nasogas- tric enteral feeding in the management of hyperemesis grav- idarum. Obstet Gynecol. 1996; 88(3): 343-346.
  • Levine MG, Esser D. Total parenteral nutrition for the treatment of severe hyperemesis gravidarum: maternal nutri- tional effects and fetal outcome. Obstet Gynecol. 1988; 72(1): 102
  • Rayburn W, Wolk R, Mercer N, Roberts J. Parenteral nu- trition in obstetrics and gynecology. Obstet Gynecol Surv. 1986; 41(4): 200-214.
  • Rosen T, de Veciana M, Miller HS, Stewart L, Rebarber A, Slotnick RN. A randomized controlled trial of nerve stim- ulation for relief of nausea and vomiting in pregnancy. Obstet Gynecol. 2003; 102(1): 129-135.
  • Koch KL, Stern RM, Vasey M, Botti JJ, Creasy GW, Dw- yer A. Gastric dysrhythmias and nausea of pregnancy. Dig Dis Sci. 1990; 35(8): 961-968.

hiperemezis gravidarum tedavisnde güncel yaklaşımlar

Yıl 2014, Cilt: 5 Sayı: 2, 72 - 76, 27.04.2014

Öz

Hiperemezis gravidarum, diğer adıyla gebeliğin inatçı bulantı kusması, kilo kaybı, elektrolit düzensizliği ve böbrek fonksiyon bozukluğu ile seyredebilen fetusa ciddi etkileri olabilen bir gebelik komplikasyonudur. Gebeliklerin %80’den fazlasında bulantı kusma görülmesine rağmen hiperemezis gravidarum gebeliklerin % 0,3-2’ni komplike eder. Hiperemezis gravidarumun hem maternal hem fetal olumsuz etkileri olabilir. Tedavisinde yaşam şekli değişikliği, diyet, non farmakolojik ajanlar, psikoterapi ve anti-emetikler, gibi pek çok modalite uygulanmaktadır

Kaynakça

  • Broussard CN, Richter JE. Nausea and vomiting of preg- nancy. Gastroenterol Clin North Am. 1998; 27(1): 123-151.
  • Abell TL, Riely CA. Hyperemesis gravidarum. Gastroen- terol Clin North Am. 1992; 21(4): 835-849.
  • Tan PC, Khine PP, Vallikkannu N, Omar SZ. Prometha- zine compared with metoclopramide for hyperemesis grav- idarum: a randomized controlled trial. Obstet Gynecol. 2010; 115(5): 975-981.
  • Jueckstock JK, Kaestner R, Mylonas I. Managing hyper- emesis gravidarum: a multimodal challenge. BMC Med. 2010; 8: 46.
  • Goodwin TM. Hyperemesis gravidarum. Clin Obstet Gy- necol. 1998; 41(3): 597-605.
  • Simon EP, Schwartz J. Medical hypnosis for hyperemesis gravidarum. Birth. 1999; 26(4): 248-254.
  • Sonkusare S. Hyperemesis gravidarum: a review. Med J Malaysia. 2008; 63(3): 272-6; quiz 7.
  • Tan PC, Jacob R, Quek KF, Omar SZ. Pregnancy outcome in hyperemesis gravidarum and the effect of laboratory clin- ical indicators of hyperemesis severity. J Obstet Gynaecol Res. 2007; 33(4): 457-464.
  • Carlsson CP, Axemo P, Bodin A, Carstensen H, Ehren- roth B, Madegard-Lind I, Navander C. Manual acupuncture reduces hyperemesis gravidarum: a placebo-controlled, randomized, single-blind, crossover study. J Pain Symptom Manage. 2000; 20(4): 273-279.
  • Borgeat A, Fathi M, Valiton A. Hyperemesis gravidarum: is serotonin implicated? Am J Obstet Gynecol. 1997; 176(2): 476-4
  • Taylor R. Successful management of hyperemesis grav- idarum using steroid therapy. QJM. 1996; 89(2): 103-107.
  • Fischer-Rasmussen W, Kjaer SK, Dahl C, Asping U. Gin- ger treatment of hyperemesis gravidarum. Eur J Obstet Gy- necol Reprod Biol. 1991; 38(1): 19-24.
  • Eliakim R, Abulafia O, Sherer DM. Hyperemesis grav- idarum: a current review. Am J Perinatol. 2000; 17(4): 207- 2
  • Chong W, Johnston C. Unsuspected thyrotoxicosis and hyperemesis gravidarum in Asian women. Postgrad Med J. 1997; 73(858): 234-236.
  • Kuscu NK, Koyuncu F. Hyperemesis gravidarum: current concepts and management. Postgrad Med J. 2002; 78(916): 76
  • Poursharif B, Korst LM, Macgibbon KW, Fejzo MS, Romero R, Goodwin TM. Elective pregnancy termination in a large cohort of women with hyperemesis gravidarum. Con- traception. 2007; 76(6): 451-455.
  • Bailit JL. Hyperemesis gravidarium: Epidemiologic find- ings from a large cohort. Am J Obstet Gynecol. 2005; 193(3 Pt 1): 811-814.
  • Dodds L, Fell DB, Joseph KS, Allen VM, Butler B. Out- comes of pregnancies complicated by hyperemesis grav- idarum. Obstet Gynecol. 2006; 107: 285-292.
  • Veenendaal MV, van Abeelen AF, Painter RC, van der Post JA, Roseboom TJ. Consequences of hyperemesis grav- idarum for offspring: a systematic review and meta-analysis. BJOG. 2011; 118(11): 1302-1313.
  • 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.
  • Tsang IS, Katz VL, Wells SD. Maternal and fetal out- comes in hyperemesis gravidarum. Int J Gynaecol Obstet. 1996; 55(3): 231-235.
  • Ebrahimi N, Maltepe C, Bournissen FG, 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): 803-807.
  • Power Z, Campbell M, Kilcoyne P, Kitchener H, Waterman H. The Hyperemesis Impact of Symptoms Questionnaire: development and validation of a clinical tool. Int J Nurs Stud. 2010; 47(1): 67-77.
  • Lacasse A, Rey E, Ferreira E, Morin C, Berard A. 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): 71-77.
  • Ismail SK, Kenny L. Review on hyperemesis gravidarum. Best Pract Res Clin Gastroenterol. 2007; 21(5): 755-769.
  • Ozerkan K, Küçükkömürcü Ş, Özdil M, Arslan E, Saraydaroğlu Ö. Hiperemezis Gravidarum ve Mide Kanseri. Turkiye Klinikleri J Gynecol Obst . 2007; 17(3): 224-227.
  • Aslan E, Şimşek E, Kılıçdağ E, Bolat F, Nursal TZ, Haydardedeoğlu B. Hiperemezis gravidarum ayırıcı tanısında mide kanseri: Olgu sunumu. J Turk Soc Obstet Gynecol. 2008; 5(1): 36-39.
  • Jednak MA, Shadigian EM, Kim MS, Woods ML, Hooper FG, Owyang C, asler WL. Protein meals reduce nausea and gastric slow wave dysrhythmic activity in first trimester pregnancy. Am J Physiol. 1999; 277: 855-861.
  • Nelson-Piercy C. Treatment of nausea and vomiting in pregnancy. When should it be treated and what can be safely taken? Drug Saf. 1998; 19(2): 155-164.
  • Shrim A, Boskovic R, Maltepe C, Navios Y, Garcia- Bournissen F, Koren G. Pregnancy outcome following use of large doses of vitamin B6 in the first trimester. J Obstet Gynaecol. 2006; 26(8): 749-751.
  • Einarson A, Maltepe C, Boskovic R, Koren G. Treatment of nausea and vomiting in pregnancy: an updated algorithm. Can Fam Physician. 2007; 53(12): 2109-2111.
  • Hornby PJ. Central neurocircuitry associated with emesis. Am J Med. 2001; 111 Suppl 8A: 106S-112S.
  • Sheean PM, Braunschweig CA. Exploring the clinical characteristics of parenteral nutrition recipients admitted for initial hematopoietic stem cell transplantation. J Am Diet Assoc. 2007; 107(8): 1398-1403.
  • World MJ. Ondansetron and hyperemesis gravidarum. Lancet. 1993 16; 341(8838): 185.
  • Sullivan CA, Johnson CA, Roach H, Martin RW, Stewart DK, Morrison JC. A pilot study of intravenous ondansetron for hyperemesis gravidarum. Am J Obstet Gynecol. 1996; 174(5): 1565-1568.
  • Festin M. Nausea and vomiting in early pregnancy. Clin Evid (Online). 2009; 2009.
  • Mazzotta P, Magee LA. A risk-benefit assessment of pharmacological and nonpharmacological treatments for nausea and vomiting of pregnancy. Drugs. 2000; 59(4): 781- 800.
  • Tan PC, Omar SZ. Contemporary approaches to hyperemesis during pregnancy. Curr Opin Obstet Gynecol. 2011; 23(2): 87-93.
  • Ferreira E, Gillet M, Lelievre J, Bussieres JF. Ondansetron use during pregnancy: a case series. J Popul Ther Clin Pharmacol. 2012; 19(1): 1-10.
  • Einarson A, Maltepe C, Navioz Y, Kennedy D, Tan MP, Koren G. The safety of ondansetron for nausea and vomiting of pregnancy: a prospective comparative study. BJOG. 2004; 111(9): 940-943.
  • Asker C, Norstedt Wikner B, Kallen B. Use of antiemetic drugs during pregnancy in Sweden. Eur J Clin Pharmacol. 2005; 61(12): 899-906.
  • Tan PC, Yow CM, Omar SZ. A placebo-controlled trial of oral pyridoxine in hyperemesis gravidarum. Gynecol Obstet Invest. 2009; 67(3): 151-157.
  • Nageotte MP, Briggs GG, Towers CV, Asrat T. Droperidol and diphenhydramine in the management of hyperemesis gravidarum. Am J Obstet Gynecol. 1996; 174(6): 1801-1805; discussion 5-6.
  • Lacasse A, Lagoutte A, Ferreira E, Berard A. Metoclopramide and diphenhydramine in the treatment of hyperemesis gravidarum: effectiveness and predictors of rehospitalisation. Eur J Obstet Gynecol Reprod Biol. 2009; 143(1): 43-49.
  • Ditto A, Morgante G, la Marca A, De Leo V. Evaluation of treatment of hyperemesis gravidarum using parenteral fluid with or without diazepam. A randomized study. Gynecol Obstet Invest. 1999; 48(4): 232-236.
  • Reichmann JP, Kirkbride MS. Nausea and vomiting of pregnancy: cost effective pharmacologic treatments. Manag Care. 2008; 17(12): 41-45.
  • Tasci Y, Demir B, Dilbaz S, Haberal A. Use of diazepam for hyperemesis gravidarum. J Matern Fetal Neonatal Med. 2009; 22(4): 353-356.
  • Park-Wyllie L, Mazzotta P, Pastuszak A, Moretti ME, Beique L, Hunnisett L, Friesen MH, Jacobson S, Kasapi- novic S, Chang D, Diav-Citrin O, Chitayat D, Nulman I, Ein- arson TR, Koren G. Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies. Teratology. 2000; 62(6): 385-392.
  • Dolovich LR, Addis A, Vaillancourt JM, Power JD, Ko- ren G, Einarson TR. Benzodiazepine use in pregnancy and major malformations or oral cleft: meta-analysis of cohort and case-control studies. BMJ. 1998; 317(7162): 839-843.
  • Schwarzer V, Heep A, Gembruch U, Rohde A. Treatment resistant hyperemesis gravidarum in a patient with type 1 diabetes mellitus: neonatal withdrawal symptoms after suc- cessful antiemetic therapy with mirtazapine. Arch Gynecol Obstet. 2008; 277(1): 67-69.
  • Safari HR, Fassett MJ, Souter IC, Alsulyman OM, Good- win TM. The efficacy of methylprednisolone in the treatment of hyperemesis gravidarum: a randomized, double-blind, controlled study. Am J Obstet Gynecol. 1998; 179(4): 921- 9
  • Vutyavanich T, Kraisarin T, Ruangsri R. Ginger for nau- sea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial. Obstet Gynecol. 2001; 97(4): 577- 5
  • Hsu JJ, Clark-Glena R, Nelson DK, Kim CH. Nasogas- tric enteral feeding in the management of hyperemesis grav- idarum. Obstet Gynecol. 1996; 88(3): 343-346.
  • Levine MG, Esser D. Total parenteral nutrition for the treatment of severe hyperemesis gravidarum: maternal nutri- tional effects and fetal outcome. Obstet Gynecol. 1988; 72(1): 102
  • Rayburn W, Wolk R, Mercer N, Roberts J. Parenteral nu- trition in obstetrics and gynecology. Obstet Gynecol Surv. 1986; 41(4): 200-214.
  • Rosen T, de Veciana M, Miller HS, Stewart L, Rebarber A, Slotnick RN. A randomized controlled trial of nerve stim- ulation for relief of nausea and vomiting in pregnancy. Obstet Gynecol. 2003; 102(1): 129-135.
  • Koch KL, Stern RM, Vasey M, Botti JJ, Creasy GW, Dw- yer A. Gastric dysrhythmias and nausea of pregnancy. Dig Dis Sci. 1990; 35(8): 961-968.
Toplam 57 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Derlemeler
Yazarlar

Esra Tola

Yayımlanma Tarihi 27 Nisan 2014
Gönderilme Tarihi 12 Aralık 2012
Yayımlandığı Sayı Yıl 2014 Cilt: 5 Sayı: 2

Kaynak Göster

Vancouver Tola E. hiperemezis gravidarum tedavisnde güncel yaklaşımlar. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2014;5(2):72-6.

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