• Title/Summary/Keyword: nausea and vomiting in pregnancy

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A Case Report: Effect of Korean Medicine Including Distilled Form of Bosaeng-tang Gagambang on Moderate to Severe Hyperemesis Gravidarum.

  • Kim, Hae-Won;Baek, Seon-Eun;Yoo, Dong-Youl;Yoo, Jeong-Eun
    • The Journal of Korean Medicine
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    • v.41 no.4
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    • pp.120-132
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    • 2020
  • Objectives: Hyperemesis gravidarum (HG) is defined as severe nausea and vomiting during pregnancy (NVP) with weight loss, ketonuria, and electrolyte imbalance. Many NVP or HG patients get hard to take herbal medicine since the smell and taste of it. Therefore, the distilled herbal medicines are often used in clinical practice. A 32-year-old, 14-week pregnant female was admitted for 3 weeks at a Korean medicine hospital. She was experiencing HG accompanied by 19.61% (10 kg) weight loss, ketonuria, and electrolyte imbalance. The patient received Bosaeng-tang gagambang in its distilled form, acupuncture, electro-acupuncture, sticker needles, cupping, moxibustion, and hydration during admission. The severity and frequency of NVP, weight loss, and ketonuria significantly improved without any side effects. Before the therapy, she admitted to two obstetrics and gynecology hospitals, 1 week each, with no improvement. This case presents the therapeutic potential of Korean medicine including herbal medicine in its diluted form for HG and NVP.

A STUDY TO DETERMINE THE LEVEL OF OBSTETRIC KNOWLEDGE OF PREGNANT WOMEN AND POSTPARTUM MOTHERS (병원을 이용하는 임산부들의 산과적 지식정도에 관한 일 조사 연구)

  • 이선자
    • Journal of Korean Academy of Nursing
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    • v.4 no.3
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    • pp.81-91
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    • 1974
  • The purpose of this study was to investigate the level of obstetric knowledge of pregnant women and postpartum mothers, and to contribute the data to community health teaching program as well as maternity nursing. 385 pregnant women and postpartum mothers visited at or admitted to Seoul Adventist Hospital were sampled. The results of the study were as follows. 1. 97.9% of the subjects were between the age of 21 to 35, most of them (82.9%) were housewives with high school education and with a middle class family background. 2. The first symptoms of pregnancy were amenorrhea (70.4%), nausea & vomiting (23.9%), change of skin color (1.6%). 3. 77.9% of the subjects did not know how to deal with morning sickness. 4. 52.9% did not know when the sex determination of the fetus-occurs. 5. Concerning the fetus position; 77.1% of them believed it lies head down. head up (12.0%). and not knowing (10.9%). 6. 73.2% recognized the need for a well balanced food during pregnancy. 7. As to the dangerous symptoms during pregnancy: vaginal bleeding was considered the 1st, edema, the and, continuous abdominal pain, the 3rd. 82% of them would confer with physician in case of vaginal bleeding. As to the type of activities restricted by pregnancy: hard exercise was considered first, travel the second, and coitus during 1st and last trimester of pregnancy the 3rd. 8. 82.4% of them visited antenatal clinic at the second or third month of amenorrhea and 88.5% realized the regular physical examination imperative. 9. The purpose of urine test was recognized correctly by 44.7%, blood test: 89.4%, B. P. and weight check ; 69.9%. 10. The need of breast care during pregnancy was recognized by 76.9% of the subject. 11. 75.8% realized that prenatal exercise was needed. The higher the education the better the understanding of the need for it before delivery. 12. The concept of postpartum period was understood correctly by 54.4%. 13. The state of uterus after delivery was understood correctly by 49.1% only. 14, Regarding the management of colostrums: 48.3% knew it was to feed infants, and it was to squeeze and discard 43.4%. 15. Dealing with postpartum exercise; 67.8% answered it was needed, 9.1% not needed, not heard about 23, 1%.

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Investigation of Clinical Research of Acupuncture Treatment on Hyperemesis Gravidarum in Medline (Medline 검색을 통한 임신오저에 대한 국외 침치료의 연구 동향 분석)

  • Kim, Eun-Gyung;Hwang, Deok-Sang;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bok;Lee, Kyung-Sub
    • The Journal of Korean Obstetrics and Gynecology
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    • v.25 no.4
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    • pp.66-80
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    • 2012
  • Purpose: The purpose of this study is to examine acupuncture treatment suggested on the papers of hyperemesis gravidarum(HG) in medicine journals and to establish the future direction. Methods: The papers which were associated with acupuncture and HG published between 2000 and 2012 in Medline were searched. Results: 14 studies met the condition. They were 13 randomized controlled trial (RCT)s and 1 clinical study. 13 studies revealed that acupuncture has efficacies in HG. 1 study was shown to have no statistically significant efficacy. 2 studies revealed that acupuncture was safe treatment, and 1 study revealed that acupuncture was reliable treatment. Conclusions: From the paper research, acupuncture treatment seems to be effective on HG. However, due to the lack sufficient research of HG, it would be necessary to fulfill further study about the period of acupuncture treatment on HG and the selection of acupoint through well-designed study and establish standard of evidence of them.

Tapentadol: Can It Kill Two Birds with One Stone without Breaking Windows?

  • Chang, Eun Jung;Choi, Eun Ji;Kim, Kyung Hoon
    • The Korean Journal of Pain
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    • v.29 no.3
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    • pp.153-157
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    • 2016
  • Tapentadol is a novel oral analgesic with a dual mode of action as an agonist of the ${\mu}$-opioid receptor (MOR), and as a norepinephrine reuptake inhibitor (NRI) all in a single molecule. Immediate release (IR) tapentadol shows its analgesic effect quickly, at around 30 minutes. Its MOR agonistic action produces acute nociceptive pain relief; its role as an NRI brings about chronic neuropathic pain relief. Absorption is rapid, with a mean maximal serum concentration at 1.25-1.5 h after oral intake. It is present primarily in the form of conjugated metabolites after glucuronidation, and excretes rapidly and completely via the kidneys. The most common adverse reactions are nausea, dizziness, vomiting, and somnolence. Constipation is more common in use of the ER formulation. Precautions against concomitant use of central nervous system depressants, including sedatives, hypnotics, tranquilizers, general anesthetics, phenothiazines, other opioids, and alcohol, or use of tapentadol within 14 days of the cessation of monoamine oxidase inhibitors, are advised. The safety and efficacy have not been established for use during pregnancy, labor, and delivery, or for nursing mothers, pediatric patients less than 18 years of age, and cases of severe renal impairment and severe hepatic impairment. The major concerns for tapentadol are abuse, addiction, seeking behavior, withdrawal, and physical dependence. The presumed problem for use of tapentadol is to control the ratio of MOR agonist and NRI. In conclusion, tapentadol produces both nociceptive and neuropathic pain relief, but with worries about abuse and dependence.

Sleep Patterns of Pregnant Women (임부의 수면양상)

  • Choi, Byeung-Sun;Yoon, Jin-Sang
    • Sleep Medicine and Psychophysiology
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    • v.5 no.1
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    • pp.45-53
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    • 1998
  • Objectives : The change of sleep patterns commonly occurs in association with the pregnancy. This study was to investigate sleep habits during the course of normal pregnancy. Methods : Sleep habits questionnaire was administered to healthy women in their first trimester(TR1) of pregnancy and then the same questionnaire was repeatedly administered during their second(TR2) and third(TR3) trimesters. The following aspects were assessed : patterns of night sleep, daytime status, sleep posture, reasons for sleep alteration, and the experience of any particular parasomnias, as well as sleep problem-related treatment or medication. Data analysis was based on 26 women who maintaind good health throughout their pregnancy and completed the questionnaire three times. Results : In comparisons between each trimester and non-pregnant state, total night sleep time, daytime tiredness, and sleepiness were significantly increased in all trimesters. Sleep latency was significantly decreased in TR1 and TR2, but not in TR3. In addition, refreshed feeling on waking the following day was significantly decreased and the number of awakenings during night sleep was significantly increased in TR3, but not in TR1 and TR2. In comparisons between trimesters, there was a significant increase in sleep latency, daytime sleepiness and the number of awakenings during night sleep and a significant decrease in refreshed feeling on waking the following day in TR3 compared to TR1 and TR2. Over the course of pregnancy, the rate of lateral position during sleep was gradually increased and all the pregnant women took the lateral sleeping posture in TR3. The major reasons for sleep pattern alteration were nausea, vomiting and heartburn in TR1, urinary frequency, fetal movement and ache in hips in TR2, and urinary frequency, fetal movement, cramp in legs and backache in TR3. Conclusion : These findings are expected to be useful for educating pregnant women about sleep hygiene. In future studies, the underlying factors and mechanisms regarding sleep patterns during pregnancy will need to be clarified.

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Study on the Acceptability and Effectiveness of an Oral Contraceptive Among Iud Drop-outs in Rural Korea

  • Yang, J.M.;Bang, S.;Song, S.W.;Youn, B.B.
    • Journal of Preventive Medicine and Public Health
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    • v.1 no.1
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    • pp.51-66
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    • 1968
  • During a period of about one year(November '66 to December '67), the Yonsei University College of Medicine conducted a field trial of the oral contraceptive(Ovulen) in order to study its acceptability and use-effectiveness among IUD drop-outs in Koyang county. We can summarize the outstanding findings from this investigation as follows; 1. 61.4% of the IUD drop-outs interviewed (911 women) wanted to use the pill. Most of the reasons for not wanting to use it(352 women) pertained to either use of other contraceptive methods(98) or subfecundity(150) following IUD terminations. Only 83 out of 911 women gave reasons related to the difficulty of obtaining pills. Therefore, we can state that most IUD drop-outs if still in need of a contraceptive methods are in favor of trying the pill, and especially so if this method is conveniently available. 2. The 467 women or 37% of those who terminated IUD use actually visited the clinic for medical screening, and only 11 of them or 2.4% were rejected because of pregnancy and other medical reasons such as cervical erosion, myoma, breast mass, etc. 5.5% or 25 of the 456 women who received the first cycle did not take a single pill during the study period. 3. When we defined those 431 women who accepted and took one or more tablets we found that women over age 30, with 4 or more children, and/or with a higher educational level were the best prospects for recruitment. 4. In accuracy of use, about two thirds of the users started taking the pill on the 5 th day as directed for the first three cycles, but the percentages rose sharply to about 80% in later cycles. Tardiness in starting pill use in the first cycle may have occurred partly because they had to return to the clinic monthly to get each new cycle. Among acceptors who did not quit between cycles, 80 to 90% were regular users, missing two or less tablets in each cycle. 5) More than 60% of the users felt well and sometimes lost their pre-acceptance symptoms. especially dysmenorrhea. However, 27.4% (58 women) had side effects attributable to the pill compund as nausea, vomiting, indigestion, breast tenderness, decreased lactation or breakthrough bleeding. 25.0% (53 women) also complained of medical diseases or symptoms not related to the pill, especially during the first three cycles. However, as the confidence and experience of the client and the field workers grew, the incidence of unrelated medical complaints quickly fell to a lower level in the later cycles. 6. As of the end of this study, on December 31, 1967, 49.2% (212 women) had discontinued the use of the pill for medical reasons as well as for the non medical reasons. Only one case terminated use due to a pregnancy after taking pills. The cumulative continuation rates (by the life table method), were 58.9%, 51.9%, 41.0% at the end of 3 months, 6 months and one year, respectively. These rates are lower than in the U.S. studies. Even when we add the retaking group to the first segment, the continuation rate goes up only about 5% above the first segment rates mentioned above. Possible explanations are different dosages, the newerness of the method and the use of only one point for pill distribution in the country together with a monthly return for cycle 1, 2, 3, and 4-6.

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