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Treatments for hyperemesis gravidarum: A systematic review
Umea Univ, Sweden.
Univ Gothenburg, Sweden.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Children's and Women's Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
Swedish Agcy Hlth Technol Assessment & Assessment, Sweden.
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2024 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 103, no 1, p. 13-29Article, review/survey (Refereed) Published
Abstract [en]

IntroductionHyperemesis gravidarum affects 0.3%-3% of pregnant women each year and is the leading cause of hospitalization in early pregnancy. Previous systematic reviews of available treatments have found a lack of consistent evidence, and few studies of high quality. Since 2016, no systematic review has been conducted and an up-to date review is requested. In a recent James Lind Alliance collaboration, it was clear that research on effective treatments is a high priority for both patients and clinicians.Material and methodsSearches without time limits were performed in the AMED, CINAHL, Cochrane Library, EMBASE, Medline, PsycINFO, and Scopus databases until June 26, 2023. Studies published before October 1, 2014 were identified from the review by ODonnell et al., 2016. Selection criteria were randomized clinical trials and non-randomized studies of interventions comparing treatment of hyperemesis gravidarum with another treatment or placebo. Outcome variables included were: degree of nausea; vomiting; inability to tolerate oral fluids or food; hospital treatment; health-related quality of life, small-for-gestational-age infant; and preterm birth. Abstracts and full texts were screened, and risk of bias of the studies was assessed independently by two authors. Synthesis without meta-analysis was performed, and certainty of evidence was assessed using the GRADE approach. PROSPERO (CRD42022303150).ResultsTwenty treatments were included in 25 studies with low or moderate risk of bias. The certainty of evidence was very low for all treatments except for acupressure in addition to standard care, which showed a possible moderate decrease in nausea and vomiting, with low certainty of evidence.ConclusionsSeveral scientific knowledge gaps were identified. Studies on treatments for hyperemesis gravidarum are few, and the certainty of evidence for different treatments is either low or very low. To establish more robust evidence, it is essential to use validated scoring systems, the recently established diagnostic criteria, clear descriptions and measurements of core outcomes and to perform larger studies. The certainty of evidence according to GRADE (The Grading of Recommendations Assessment, Development and Evaluation) was very low for all treatments of hyperemesis gravidarum except for acupressure in addition to standard care, which showed a possible moderate decrease in nausea and vomiting, with low certainty of evidence.image

Place, publisher, year, edition, pages
WILEY , 2024. Vol. 103, no 1, p. 13-29
Keywords [en]
hyperemesis gravidarum; intervention; nausea; PUQE; quality of life; systematic review; treatment; vomiting
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:liu:diva-199107DOI: 10.1111/aogs.14706ISI: 001088462100001PubMedID: 37891710OAI: oai:DiVA.org:liu-199107DiVA, id: diva2:1811516
Note

Funding Agencies|Statens beredning for medicinsk och social utvardering; Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU Statens beredning for medicinsk och social utvardering, SBU); Ministry of Health and Social Affairs in Sweden

Available from: 2023-11-13 Created: 2023-11-13 Last updated: 2024-03-15

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Claesson, Ing-Marie
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Division of Children's and Women's HealthFaculty of Medicine and Health SciencesDepartment of Gynaecology and Obstetrics in Linköping
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