Intractable hyperemesis gravidarum in a patient with type 1 diabetes

Arshad, Muhammad Fahad; Javed, Nasir; Bekhit, Mohammad

doi:10.1136/bcr-2017-222403

Cited by 2 publications

(3 citation statements)

References 10 publications

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“…The effect was equally fast and beneficial as the other reports, with the patient gaining almost 10 kg during pregnancy. Only two authors reported weight gain in their patients: 2.5 kg in Arshad et al and almost 16 kg for one of the cases described by Saks [ 6 , 20 ]. The number of antiemetic medication used was higher than the average of the other papers (8 × 2.8) and higher than the maximum used in other case reports [ 8 ].…”

Section: Discussion and Systematic Reviewmentioning

confidence: 99%

“…If the two cases by Uguz et al were considered to be unpublished, there would be 30 cases [12], and none of them in Latin America. These case reports have been described in Europe, North America, and Turkey [6,[11][12][13][14][15][16][17][18][19][20]. After analysis of each patient, we have a global assessment of data, as shown in Tables 2 and 3.…”

Section: Discussion and Systematic Reviewmentioning

confidence: 99%

“…Arshad et al, [20] Doncaster, United Kingdom (UK) Gastroenterology + endocrinology + obstetrics and gynecology 1…”

Section: Authormentioning

confidence: 99%

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Use of Mirtazapine and Olanzapine in the Treatment of Refractory Hyperemesis Gravidarum: A Case Report and Systematic Review

Galletta

Tess

Pasotti

et al. 2022

Case Reports in Obstetrics and Gynecology

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Hyperemesis gravidarum (HG) is a rare condition (1.1%) characterized by excessive vomiting, malnutrition, dehydration, and laboratorial alterations. Herein, we describe the even rarer and serious presentation of refractoriness to the usual treatment of antiemetics and parenteral nutrition, with improvement only after the use of olanzapine and mirtazapine. Two subsequent pregnancies of the same woman with HG are described, which were associated with severe weight loss, anemia, hyponatremia, hypokalemia, and mild dysfunction of liver enzymes. In the third pregnancy, the usual treatment for HG was not successful, requiring enteral nutrition and the introduction of olanzapine. In the fourth pregnancy, the patient refused to use enteral nutrition for refractory HG. Hence, the patient was started on mirtazapine at an initial dose of 15 mg/day, which was gradually increased to 30 mg/day. The patient responded well to the new regimen, as demonstrated by the decrease in symptoms, the gain of 10 kg in the pregnancy, and delivering a healthy newborn. A systematic review of literature showed 11 articles and 30 cases that successfully used mirtazapine in HG. Good clinical outcomes were seen with 4 days of the treatment and at an initial dose of 15 mg/day. However, most of these reports were from psychiatric profiles, with a predominance of depression and anxiety symptoms, and a poor description of the obstetric conditions and the disease progression itself. Pulmonary hypertension was described in one case and neonatal hyperexcitability in another. The case described in this paper reinforces the idea that mirtazapine and olanzapine can be considered in refractory HG, with good results. In the world literature, this is the second case of HG that has been successfully treated with olanzapine and the first in Latin America treated with mirtazapine.

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Section: Discussion and Systematic Reviewmentioning

confidence: 99%

Section: Discussion and Systematic Reviewmentioning

confidence: 99%

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Use of Mirtazapine and Olanzapine in the Treatment of Refractory Hyperemesis Gravidarum: A Case Report and Systematic Review

Galletta

Tess

Pasotti

et al. 2022

Case Reports in Obstetrics and Gynecology

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Modern Concepts of Vomiting of Pregnancy

KURBANOVA

2023

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This review discusses some aspects of the most common complication of the early gestational period – toxicosis. Vomiting of pregnant women (VP) is one of the frequent manifestations of early toxicosis. This disorder affects the quality of life of a pregnant woman, causes exhaustion, and contributes to the disruption of homeostasis, weakness, and dysfunction of various organs and systems. In addition, it may lead to miscarriage, placental insufficiency, insufficient weight gain during gestation, various perinatal pathologies in children, and other complications. Therefore, VP despite numerous studies conducted throughout the world, remains one of the urgent problems of obstetrics, the solution of which requires sufficient evidence-based research. Papers on various aspects of VP from the PubMed and Google Scholar electronic databases were analyzed. More than 500 sources were found, of which 50 were selected and included in the review, based on the selected keywords. Keywords: Pregnancy, changes in the body of a pregnant woman, pregnancy complications, pregnancy toxicosis, vomiting and nausea in pregnant women, perinatal outcomes.

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Intractable hyperemesis gravidarum in a patient with type 1 diabetes

Cited by 2 publications

References 10 publications

Use of Mirtazapine and Olanzapine in the Treatment of Refractory Hyperemesis Gravidarum: A Case Report and Systematic Review

Use of Mirtazapine and Olanzapine in the Treatment of Refractory Hyperemesis Gravidarum: A Case Report and Systematic Review

Modern Concepts of Vomiting of Pregnancy

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