The management of nausea and vomiting during pregnancy

NVP affects up to 90% of pregnant women (1) and is one of the most common indications for hospital admission among pregnant women, with typical stays of between three and four days (2). NVP is defined as the symptom of nausea and/or vomiting prior to 16 weeks of gestation without other causes. (3) HG is a severe form of NVP, which affects between 0.3 and 3.6% of pregnant women, interfering with quality of life and the ability to eat and drink normally. Reported HG recurrence rates vary, from 15.2% to 89% if using self-reported diagnosis. (4) In a population-based pregnancy cohort using general practice records prevalence of clinically recorded NVP/HG was 9.1%: 2.1% had hospital admissions, 3.4% were treated with antiemetics in primary care only, and 3.6% had only recorded diagnoses. (5) The major mechanism of NVP and HG has recently been elucidated to be related to hypersensitivity to the vomiting hormone growth differentiation factor-15 (GDF15). GDF15 caused loss of appetite, taste aversion, nausea, vomiting and weight loss. hCG is unlikely to be causative. (6) Prevalence data specifically for general NVP in Egypt is limited, but studies showed that severe NVP and HG occurs in 0.5% to 2% of all pregnancies and result in a high hospital rate of 4.5% in some regions (7), which is considered high compared to universal figures.