MIP: Hyperemesis Gravidarum (2018)

MIP: Hyperemesis Gravidarum (2018)

• Intervention
  Which nutrition interventions [in terms of total parenteral nutrition (TPN) vs. non-TPN] are effective in preventing malnutrition in pregnant women with hyperemesis gravidarum?

  • Conclusion
    Based on evidence from one study, the TPN group appeared to have greater TPN-related complications but not non-TPN-related complications when compared with the non-TPN group among women with hyperemesis gravidarum.
  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Which nutrition interventions (in terms of total parenteral nutrition (TPN) vs. non-TPN) are effective in preventing malnutrition in pregnant women with hyperemesis gravidarum?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Folk J, Leslie-Brown H, Nosovitch J, Silverman R, Aubry R. Hyperemesis gravidarum: outcomes and complications with and without total parenteral nutrition. The Journal of Reproductive Medicine. 2004; 49:497-502.
  • Search Plan and Results: MIP: Hyperemesis Gradivarum (2015)
     
  Which nutrition interventions [in terms of peripherally inserted central catheters (PICC) line vs. nasogastric (NG)/nasoduodenal (ND) tube vs. medication only] are effective in preventing malnutrition in pregnant women with hyperemesis gravidarum?

  • Conclusion
    Based on evidence from one study, there were no significant differences in neonatal outcomes among PICC line, NG/ND tube and medication only groups among women with hyperemesis gravidarum. Compared to the medication only group, the PICC line group appeared to have significantly greater maternal complications but no significant differences were noted in the NG/ND group. 
  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Which nutrition interventions (in terms of peripherally inserted central catheters (PICC) line vs. nasogastric (NG)/nasoduodenal (ND) tube vs. medication only) are effective in preventing malnutrition in pregnant women with hyperemesis gravidarum?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Holmgren C, Aagaard-Tillery K, Silver R, Porter T, Varner M. Hyperemesis in pregnancy: an evaluation of treatment strategies with maternal and neonatal outcomes. American Journal of Obstetrics and Gynecology 2008; 198:56.e1-56.e4
  • Search Plan and Results: MIP: Hyperemesis Gradivarum (2015)
     
  Which nutrition interventions (in terms of dextrose-saline vs. normal saline) are effective in preventing malnutrition in pregnant women with hyperemesis gravidarum?

  • Conclusion
    Based on evidence from one study, both dextrose-saline and normal saline resulted in similar maternal outcomes among women with hyperemesis gravidarum.
  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Which nutrition interventions (in terms of dextrose-saline vs. normal saline) are effective in preventing malnutrition in pregnant women with hyperemesis gravidarum?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Tan P,Norazilah M,Omar S. Dextrose saline compared with normal saline rehydration of hyperemesis gravidarum: a randomized controlled trial. Obstetrics and gynecology 2013; 121:291-8
  • Search Plan and Results: MIP: Hyperemesis Gradivarum (2015)