Pregnancy Nausea Related to Women&amp;rsquo;s Obstetric and Personal Histories

Gadsby, Roger; Barnie-Adshead, A M; Jagger, Carol

doi:10.1159/000291833

Cited by 70 publications

(52 citation statements)

References 10 publications

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“…It has been reported that cigarette confers protection against PONV due to presence of an anti-emetic substance in tobacco smoke [28]. A number of epidemiological studies have shown that women who smoke during pregnancy are affected by nausea of pregnancy to a much lesser degree than those who do not [29]. The pharmacological receptors which mediate PONV are known to act at the dopamine (D2), cholinergic, histamine (H1), 5-HT3 and NK1 receptors and if there were an antemetic in cigarette smoke it would have to belong to one of these classes of receptor-blocking drugs.…”

Section: Discussionmentioning

confidence: 99%

Breast Augmentation: Reducing Postoperative Nausea and Vomiting. A Prospective Study

Keramidas¹,

Vasileiou²,

Pascovitis³

et al. 2017

JACCOA

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Background: Breast augmentation is the plastic surgery procedure associated with the greatest risk of postoperative nausea and vomiting (PONV). The purpose of this study is to evaluate the efficacy of a specific antiemetic protocol applied in breast augmentation in order to diminish the incidence of PONV Methods: A prospective-level of evidence II-study was performed in 247 patients that underwent breast augmentation from October 2010 to October 2014. General anesthesia was induced with propofol, fentanyl and rocuronium. Anesthetic maintenance was accomplished with total intravenous anesthesia and air with oxygen at 50%. All patients received metoclopramide 10 mg intravenously (iv) and 8 mg of ondasetron iv (2 mg at the induction and 6 mg over 30 minutes). Intergroup comparison of means was performed using unpaired t tests and analysis of variance, where applicable.Results: Nausea and emesis occurred with an overall frequency of 4.9% and 2.8% respectively. The 95.1 percent of the patient didn't complaint having nausea on the day of operation, and only 3 (1.2%) of them had this symptom remaining until the fifth post op day. Only 7 patients reported vomiting on the day of the operation. There is no significant difference in nausea between smokers and no smokers (p= 0.510). Conclusion:Τhe specific antiemetic protocol applied in breast augmentation operations seems to be highly effective. The fact that we observed no difference between smokers and nonsmokers regarding the incidence of PONV should be further investigated since till now a protective role for smoking against PONV was suggested. Introduction 1Postoperative nausea and vomiting (PONV) are common adverse effects that occur after several types of surgical procedures. The general incidence of vomiting is about 30%, the incidence of nausea is about 50%, and in high-risk patients, the PONV rate can be as high as 80% [1][2][3]. The mechanism of PONV is multifactorial and not well-deciphered. The emesis reflex is coordinated by the vomiting center, located in the hindbrain within the medulla oblongata in close proximity to the chemoreceptor trigger zone within the area postrema. Stimuli from peripheral organs and tissues, including the genitalia are transmitted to the vomiting center by the afferent neurons of the vagus nerve [4].However, not all patients have the same risk profile for PONV. The incidence of PONV varies with patient-related factors, the nature of surgery performed, type of anesthesia used, and duration of surgery and perioperative management of the patient (Table 1) [5]. The risk of PONV in adult women has been found to be two to three times greater than in adult men. Progesterone 1 Presented:1) The 12th Congress of the ESPRAS -July 6-11, 2014, Edinburgh, Scotland.2) 22nd Congress of the ISAPS -September 19-22, 2014 Rio de Janeiro, Brazil.3) Accepted for presentation in Euroanaesthesia 2016 London UK May 28-30. or serum gonadotropin seem to be the contributing factor in the higher incidence of PONV in women [5,6]. Furthermore, obese p...

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Section: Discussionmentioning

confidence: 99%

Breast Augmentation: Reducing Postoperative Nausea and Vomiting. A Prospective Study

Keramidas¹,

Vasileiou²,

Pascovitis³

et al. 2017

JACCOA

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“…There are a number of theories regarding its aetiology [25,26], but a change in concentration of steroid hormones is thought to be the most likely cause [27]. A number of epidemiological studies have shown that women who smoke during pregnancy are affected to a much lesser degree than those who do not [28]. It would seem reasonable to conclude that smoking in this group of patients exerts its beneficial effects through similar mechanisms as in the patients whose well-being is improved postoperatively.…”

Section: Discussionmentioning

confidence: 99%

The effect of smoking on postoperative nausea and vomiting

Chimbira

Sweeney

2000

Anaesthesia

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SummaryIn an attempt to quantify the postoperative effects of smoking, 327 consecutive patients undergoing arthroscopic day case knee surgery were given a standard anaesthetic consisting of an intravenous induction with propofol and fentanyl followed by inhalational maintenance using isoflurane in an oxygen and nitrous oxide mixture. Pre-operatively, patients were asked inter alia to give details of social smoking habits. Postoperatively, patients were given standard analgesic and anti-emetic drugs. Prior to discharge patients were asked to give details of postoperative nausea and vomiting together with details of the severity of postoperative pain. There were 85 smokers and 242 nonsmokers. Of the 327 patients, a total of 42 (13%) complained of postoperative nausea and vomiting. Of the smokers, only 6% complained of postoperative nausea and vomiting in contrast to 15% of the nonsmokers (p , 0.05). It is postulated that enzyme induction is the most likely reason for this anti-emetic effect. Possible ways in which this clinically beneficial mechanism can be utilised to improve outcome after anaesthesia are discussed.

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“…Until recently most research on nausea and vomiting of pregnancy focused on its proximate causes, both hormonal, reviewed by Broussard and Richter 3 and Fessler, 6 and genetic, reviewed by Gadsby et al 7 We analyzed the probable evolutionary significance of nausea and vomiting of pregnancy, focusing on 2 questions: (1) Why should physiological changes in early pregnancy result in nausea and vomiting instead of other conceivable symptoms? (2) Could nausea and vomiting possibly serve a useful function?…”

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confidence: 99%

Nausea and vomiting of pregnancy in an evolutionary perspective

Sherman

Flaxman

2002

American Journal of Obstetrics and Gynecology

128

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The proximate mechanisms underlying gestational nausea and vomiting have been intensively studied, but the possibility that the symptoms themselves serve a useful function has only recently been considered seriously. We synthesized evidence to evaluate various hypotheses for the adaptive significance of nausea and vomiting of pregnancy, as well as the possibility that symptoms are nonfunctional byproducts of pregnancy hormones. We found greatest support for the hypothesis that normal levels of nausea and vomiting of pregnancy (excluding hyperemesis) protect pregnant women and their embryos from harmful substances in food, particularly pathogenic microorganisms in meat products and toxins in strong-tasting plants. We discuss the data that support critical predictions of this "maternal and embryo protection hypothesis" (and contradict other hypotheses), as well as appropriate implications of these results. Knowledge that normal nausea and vomiting of pregnancy indicates the functioning of a woman's defense system, rather than a bodily malfunction, may reassure patients and enable health care providers to develop new ways of minimizing the uncomfortable symptoms. (Am J Obstet Gynecol 2002;186:$190-7.) Key words: Adaptation, evolution,'prophylaxis, plant toxins, microorganisms, diet "Morning sickness" is the common term for gestational nausea and vomiting. It is a complete misnomer. The uncomfortable symptoms occur throughout Waking hours, not just in the morning, and whereas "sickness" implies disease, healthy women experience the symptoms and bear healthy babies. Nausea and vomiting of pregnancy is more appropriate, descriptive, and objective.This article briefly summarizes our current understanding of the evolutionary significance of nausea and vomiting of pregnancy. Detailed data and analyses are presented elsewhere. 1, 2 The nausea and vomiting of pregnancy symptoms experienced by 90% to 95% of women do not fit the definition of"disease" (ie, "a departure from health" or "a condition that impairs a vital function"). Neither are they manifestations of physiological frailty in response to metabolic demands of pregnancy. Rather, nausea and vomiting of pregnancy is an intricate mechanism that probably evolved to serve a useful function: protecting the pregnant woman and embryo from food-borne infections and toxins. Within the normal range of symptoms, nausea and vomiting of pregnancy is appropriately considered as an adaptation. This does not imply that pregnant women should forgo treaunent of Neurobiology & Behavior, Cornell University, Ithaca, NY 14853. © 2002, Mosby, Inc. All rights reserved. 0002-9378/2002 $35.00 + 0 6/0/122593 doi: l O. 1067~mob. 2002 debilitating symptoms or avoid eating meats and vegetables. Rather, the implication is that normal levels of nausea and vomiting of pregnancy will not harm the embryo or mother and may even be beneficial to both. We hope this insight will be of some comfort to women experiencing nausea and vomiting of pregnancy a n d lead to new ways of minimizing the symp...

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Pregnancy Nausea Related to Women’s Obstetric and Personal Histories

Cited by 70 publications

References 10 publications

Breast Augmentation: Reducing Postoperative Nausea and Vomiting. A Prospective Study

Breast Augmentation: Reducing Postoperative Nausea and Vomiting. A Prospective Study

The effect of smoking on postoperative nausea and vomiting

Nausea and vomiting of pregnancy in an evolutionary perspective

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