Acute Kidney Injury Arising from Severe Hyperemesis Gravidarum: Case Report with a Review of Literatures

Sang-Min Shim,Ae-Li Ryu,Yun-Sook Kim 순천향대학교 순천향의학연구소 2015 Journal of Soonchunhyang Medical Science Vol.21 No.1

Severe hyperemesis gravidarum is a rare but potentially life-threatening it left untreated. Its serious complications are dehydration, ketosis, alkalosis from loss of hydrochloric acid, hypokalemia, and compromised pre-renal acute kidney injury. We experienced a very rare case of a 20-year-old woman who presented to the emergency department with severe hyperemesis gravidarum associated with a loss of kidney function at 25 weeks’ gestation. Her initial serum creatinine and blood urea nitrogen were 5.0 and 45.9 mg/dL, respectively. The patient underwent hemodialysis for three days and achieved a subsequent recovery of renal function. In conclusion, our case indicates that clinicians should be aware of the possibility of acute kidney injury associated with severe hyperemesis gravidarum although rare.

임신오조의 한약 치료에 대한 국내 증례 보고 고찰

강누리,황덕상,이진무,이창훈,장준복 대한한방부인과학회 2022 大韓韓方婦人科學會誌 Vol.35 No.1

Objectives: The purpose of this review is to anaylze the domestic study trends of Korean medicine treatment for hyperemesis gravidarum. Methods: We investigated the studies on Korean medicine treatment on hyperemesis gravidarum via searching four online databases up to October 2021. After searching studies, we analyzed selected studies. Results: 13 clinical studies were selected and all studies were case reports. The most common Korean Medicine used in hyperemesis gravidarum were Boseng-tang -gamibang, Gyullyeongboseng-tang, Taesanbanseok-san-gami. Rhizome of Atractylodes japonica Koidz., Pericarp of Citrus unshiu Markovich were the most commonly used herb except Root of G. uralensis Fisch.. Although the evaluation index was different for each study, most of the cases showed that hyperemesis gravidarum was improved. Conclusions: Korean medicine treatment is effective for hyperemesis gravidarum. Further large, well-designed studies are needed to establish the foundation of Korean medicine treatment for hyperemesis gravidarum. Objectives: The purpose of this review is to anaylze the domestic study trends of Korean medicine treatment for hyperemesis gravidarum. Methods: We investigated the studies on Korean medicine treatment on hyperemesis gravidarum via searching four online databases up to October 2021. After searching studies, we analyzed selected studies. Results: 13 clinical studies were selected and all studies were case reports. The most common Korean Medicine used in hyperemesis gravidarum were Boseng-tang -gamibang, Gyullyeongboseng-tang, Taesanbanseok-san-gami. Rhizome of Atractylodes japonica Koidz., Pericarp of Citrus unshiu Markovich were the most commonly used herb except Root of G. uralensis Fisch.. Although the evaluation index was different for each study, most of the cases showed that hyperemesis gravidarum was improved. Conclusions: Korean medicine treatment is effective for hyperemesis gravidarum. Further large, well-designed studies are needed to establish the foundation of Korean medicine treatment for hyperemesis gravidarum.

체외수정(IVF)후 胎氣不安을 동반한 姙娠惡阻 환자 2례 임상경과보고

김석중,김동철,백승희 대한한방부인과학회 2005 大韓韓方婦人科學會誌 Vol.18 No.2

Purpose : We had oriental treatment for the two cases of hyperemesis gravidaum with vaginal bleeding or severe abdominal pain after IVF. Hyperemesis gravidaum is a severe and intractable form of nausea and vomiting. Vaginal bleeding and severe abdominal pain in early pregnancy can be applicable to the threatened abortion. In the case of hyperemesis gravidaum and threatened abortion, western medical therapy usually has limitation. The purpose of this study is to report the effect of oriental treatment for the two cases of hyperemesis gravidaum with vaginal bleeding or severe abdominal pain after IVF. Methods : We observed and treated two patients who had hyperemesis after IVF, the one had vaginal bleeding and the other had severe abdominal pain in early pregnancy. Nausea, vomiting, vaginal bleeding and severe abdominal pain of pregnancy has not been identified. We regarded the cause of these cases as insufficiency of spleen and stomach and etc. So, the patients were treated by combination therapy of acupuncture, moxibustion and herbal medicine. Results : After oriental treatment of acupuncture, moxibustion and herbal medicine to invigorate the spleen and stomach and etc, two patients were improved. Conclusion : It is expected to increase demand of oriental treatment under the circumstance of insufficient western treatment for hyperemesis gravidaum and threatened abortion. And many researches and case studies will be needed about hyperemesis gravidaum and threatened abortion.

임신 오조증이 합병된 임신에서의 출생아의 성비에 관한 연구

조헌영 ( Hun Young Cho ),이정열 ( Jung Ryul Lee ),이유경 ( Yoo Kyong Lee ),구인상 ( In Sang Ku ),차진영 ( Jin Young Cha ),김승룡 ( Seung Ryong Kim ),박문일 ( Moon Il Park ),조삼현 ( Sam Hyun Cho ),정성로 ( Sung Ro Chung ),황윤영 ( 대한주산의학회 2002 Perinatology Vol.13 No.2

연구목적:임신 오조증이 합병된 임신부의 경우, 출생시 신생아의 성비가 정상산모의 그것과 차이를 보인다는 일부 보고가 있어, 본 연구에서는 임신 오조증과 출생 신생아의 성비와의 관련성 여부와 오조증의 정도에 따른 출생시 성비에 대해 조사를 시행하였다. 방법:1995년 1월부터 2000년 12월까지 한양대학병원 산부인과에서 임신 오조증으로 진단받고 입원 치료한 산모 중, 본원에서 최종 분만한 111명의 산모를 연구 대상으로 하고, 상기 질환력이 없이 만삭 분만한 1995명을 대조군으로 하여, 각 군의 신생아의 성비를 비교 하였다. 또한 임신 오조군을 그 정도에 따라 경증과 중증의 두 군으로 나누어, 각 군별 특성과 출생시의 성비에 대해 조사하였다. 자료의 통계적 처리는 student t-test와 chi-square test를 이용하였고 p-value가 0.05 이하인 경우에 임상적 의의가 있는 것으로 판단하였다. 결과:임신 오조군의 경우, 111명의 출생아의 성별은 65명이 여아(58.6%), 46명이 남아(41.4%)로서, 대조군에 비해 여아의 출생이 유의하게 높은 것으로 나타났다(p=0.0046). 한편 임신 오조증의경증군과 중증군 사이에서는 성비에서 유의한 차이를 보이지 않았다(p=0.4487). 결론:임신 오조증이 합병된 임신에서는 여아의 출생이 유의하게 많은 것으로 조사되었다. 한편, 임신 오조증과 여아 출생의 증가와의 관련 인자를 규명하기 위하여는 혈중 에스트로젠 또는 HCG 농도 등에 관한 조사를 시행할 필요가 있는 것으로 사료된다. Objectives:There are a few studies reporting difference in sex ratio at birth in pregnancies complicated with hyperemesis gravidarum but it has not been reported in domestic journals yet. The purpose of this study is to evaluate difference of sex ratio in hyperemesis gravidarum patients compared to normal pregnant women. Materials & Methods:We identified 111 women who were diagnosed as hyperemesis gravidarum and had delivered babies in Hanyang University Hospital between Jan. 1995 to Dec. 2000. The control group was 1995 women who had no obstetric problems including hyperemesis gravidarum during the pregnancy and had delivered baby at term. We compared the sex ratio of infant and the characteristics of these two groups. The study group was divided into two subgroups depending on the severity of disease, mild group and severe group, and difference of sex ratio in these group were also compared. We analyzed the data using student T-test and chi-square test and p-value<0.05 was considered as statistically significant. Results:Compared to sex ratio(female:male) of control group(44.8:55.2), hyperemesis gravidarum showed the sex ratio of 58.6:41.4(p=0.005). There was no further difference of sex ratio between two subgroups of hyperemesis gravidarum according to severity of disease. Conclusion:In pregnancies complicated with hyperemesis gravidarum the sex ratio of female was significantly high. The studies based on more variables and larger population would produce more accurate results.

소양인(少陽人) 임신오조(姙娠惡阻) 환자를 형방사백산(荊防瀉白散)으로 치료한 치험례

이상민,배영춘,유관석,주종천,서은희,Lee, Sang-Min,Bae, Young-Chun,Yoo, Gwan-Seok,Joo, Jong-Cheon,Seo, Eun-Hee 사상체질의학회 2004 사상체질의학회지 Vol.16 No.2

1. Objectives Hyperemesis Gravidarum is one of common symptoms clinically and caused by pregnancy. This is defined as vomiting sufficiently pernicious to produce weight loss, dehydration, acid-base imbalance. In severe case, it also leads to neurologic abnormality including confusion, gate disturbance, nystagmus. We have tried researching effect of herbal medicines, Soyangin Hyungbangsabaek-san. 2. Methods To heal the Hyperemesis Gravidarum, we used Soyangin Hyungbangsabaek-san. 3. Results Hyperemesis Gravidarum of a Soyangin patient was treated with a herb-medicine, and change of her subjective symptom & general condition was managed. 4. Conclusions The constitutional treatment with herb-medicine (Soyangin Hyungbangsabaek-san) was efficacious against Hyperemesis Gravidarum. Further study on management of this disease is needed.

이침과 한약치료를 병행한 임신오조(姙娠惡阻) 환자 4례의 증상호전 및 안전성 보고

박승혁 ( Seung Hyeok Park ),채민수 ( Min Soo Chae ),김남훈 ( Nam Hoon Kim ),황덕상 ( Deok Sang Hwang ),이진무 ( Jin Moo Lee ),이창훈 ( Chang Hoon Lee ),이경섭 ( Kyung Sub Lee ),장준복 ( Jun Bock Jang ) 대한한방부인과학회 2013 大韓韓方婦人科學會誌 Vol.26 No.3

Objectives: To identify effects and safety of Korean traditional herbal medicine and auricular acupuncture for hyperemesis gravidarum patients. Methods: Korean traditional herbal medicine and auricular acupuncture were applied to 4 hyperemesis gravidarum patients, and we investigated changes of symptoms, continuance of pregnancy, and whether they delivered or not. Results: Hyperemesis gravidarum symptom was improved in 3 patients, and 1 patient showed complete recovery. Among them, 2 patients had children by natural childbirth, 1 patient had a repeat cesarean due to previous cesarean section, and 1 patient has been maintaining pregnancy well for 25weeks. Conclusions: It is confirmed that symptoms of hyperemesis gravidarum patients were improved by Korean traditional herbal medicine and auricular acupuncture, and these medical interventions are safe.

IVF로 세쌍둥이를 임신한 여성의 임신오조 치험1례

김정아 ( Jung Ah Kim ),김동철 ( Dong Chul Kim ) 대한한방부인과학회 2015 大韓韓方婦人科學會誌 Vol.28 No.4

Objectives: The purpose of this study is to report the effects of herbal medicine and acupuncture on a triplets pregnant patient with hyperemesis gravidarum. Methods: A patient who was pregnant with triplets by in vitro fertilization (IVF) with hyperemesis gravidarum received treatment as an inpatient by herbal medicne and acupuncture. We evaluated the results of treatment by change of symptoms and visual analogue scale (VAS) about nausea. Results: After treatment, almost symptoms of hyperemesis gravidarum were improved. Vomiting and VAS of nausea were reduced and intaking was increased as treatment. Conclusions: This study suggests that Korean medicine mainly herbal medicine and acupuncture is effective on a triplets pregnant patient by IVF with hyperemesis gravidarum.

비위도관을 통한 위내영양공급으로 치유된 임신오조증 2 예

안기범(Ki Bum Ahn),왕영미(Young Mee Wang),박종규(Jong Kyou Park),신옥철(Ok Cherl Shin),조정철(Jung Cherl Cho),김진호(Jin Ho Kim),홍선희(Sun Hi Hong),강창성(Chang Seong Kang) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.12

Traditionally, total parenteral nutrition(TPN) has been used when patients with hypaemesis gravidarum failed to respond to conservative management, but now many physicians attempt to enteral feeding via nasogastric tube because TPN is expensive and has many complications. Recently, we experienced 2 cases of hyperemesis gravidarum successfully managed by enteral feeding via nasogastric tube, therefore we think that this method may be carefully considered to the patients with hyperemesis gravidarum failed to respond to conservative management. So we report them with brief review of the literatures.

임신오조증으로 발생한 Wernicke`s Encephalopathy 1 예

김수평(Soo Pyung Kim),유영옥(Young Oak Lew),김대훈(Dae Hoon Kim),양용재(Yong Jae Yang),이형근(Hyung Gun Lee),임채춘(Chae Chun Rhim),나순숙(Soon Sook Nah),박동춘(Dong Chun Park),정대영(Dae Young Jeong),김재훈(Jae Hoon Kim) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.1

Hyperemesis gravidarum is a complication defined as nausea and vomiting during early pregnancy. Wernickes encephalopathy is an illness of acute onset characterized by mental disturbance, paralysis of eye movements, and ataxia of gait cause by thiamine deficiency. We recently experienced a case of Wernickes encephalopalhy due to hyperemesis gravidarum, which is treated by administration of thiamine even though outcome of serious healthy problem to both mother and fetus, and reported it with a brief review of the literature.

임신오조(姙娠惡阻) 1例에 대한 임상보고

박준식,임은미 대한한방부인과학회 2005 大韓韓方婦人科學會誌 Vol.18 No.1

Hyperemesis gravidarum is a severe and intractable form of nausea and vomiting in pregnancy. It is a diagnosis of exclusion and may result in weight loss; nutritional deficiencies; and abnormalities in fluids, electrolyte levels, and acid-base balance. The peak incidence is at 8-12 weeks of pregnancy, and symptoms usually resolve by week 16. Interestingly, nausea and vomiting of pregnancy is generally associated with a lower rate of miscarriage. The cause of severe nausea and vomiting in pregnancy has not been identified. Extreme nausea and vomiting may be related to elevated levels of estrogens or human chorionic gonadotropin. Once the diagnosis is made, treatment consists of mainly supportive care. Until vomiting is controlled, these patients should be maintained as NPO. We treated 1 patient who had hyperemesis gravidarum and visited Kyung-Won Incheon Oriental Hospital by Herbal medication, acupuncture, moxa and nega therapy and got good result from them.