ROSSANA PULCINELI VIEIRA FRANCISCO

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Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina - Líder

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Autor e Coautores FMUSP-HC Normalizados: MARCELO ZUGAIB × Autor e Coautores FMUSP-HC Normalizados: ROSSANA PULCINELI VIEIRA FRANCISCO × search.filters.applied.f.dateIssued: 2022 × Revista / Livro: Clinical and Experimental Obstetrics & Gynecology ×

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  • article 0 Citação(ões) na Scopus
    Demographic, Clinical, and Obstetrical Characterization of Women with Hyperemesis Gravidarum Using a More Restrictive Diagnosis
    (2022) GALLETTA, Marco Aurelio Knippel; DEMO, Mayra de Oliveira; PINTO, Ana Luiza Tonisi; FRANCISCO, Rossana Pulcineli Vieira; ZUGAIB, Marcelo
    Background: Hyperemesis gravidarum (HG) is a disease that occurs during pregnancy. It is relatively rare (0.3-3.6%), but with great potential for complications. Its diagnostic criteria still lack consensus, and most studies only establish the presence of uncontrollable vomiting, requiring hospitalization. The present study aimed to investigate its epidemiological profile and maternal and neonatal outcomes in a series of cases with more restrictive diagnostic criteria. Methods: A retrospective analysis of all cases admitted with a diagnosis of HG, according to more restrictive service criteria, was performed with a review of medical records and laboratory tests in a Brazilian university hospital. Results: HG was confirmed in 85 cases (0.39% incidence). The most frequent early symptoms included a weight loss >= 5% (94.4%) or >= 10% (63.9%), dehydration (76.5%), hyponatremia (49.4%), hypokalemia (40.5%), increased liver enzymes (46.4%), and transient hyperthyroidism (38.6%). Enteral nutrition was used in 7.1% of the patients, and parenteral nutrition in 1.2%. A large majority of patients was provided with a prescription of more than one drug, and the most used drugs were dimenhydrinate (87.1%), metoclopramide (85.9%), and ondansetron (38.8%). The average length of hospital stay was 15 days (1-145 days). Childbirth data were obtained from 40 patients, with 60% of births being cesarean deliveries, 35.3% premature births, 32% with low birth weight, and 7.5% stillbirths, with 12.5% of cases having postpartum complications. The overall rate for clinical complications was 30.5%. Conclusions: With well-defined and more restrictive criteria, we observed a high rate of obstetric and neonatal complications compared to international data. Thus, a correct diagnosis is essential for identifying this serious condition and to allow earlier treatment, reducing clinical, obstetric, and neonatal complications.