Nausea and vomiting of pregnancy (NVP) is a common condition that affects as many as 70% of pregnant women. Although no consensus definition is available for hyperemesis gravidarum (HG), it is typically viewed as the severe form of NVP and has been reported to occur in 0.3-10.8% of pregnant women. HG can be associated with poor maternal, fetal and child outcomes. The majority of women with NVP can be managed with dietary and lifestyle changes, but more than one-third of patients experience clinically relevant symptoms that may require fluid and vitamin supplementation and/or antiemetic therapy such as, for example, combined doxylamine/pyridoxine, which is not teratogenic and may be effective in treating NVP. Ondansetron is commonly used to treat HG, but studies are urgently needed to determine whether it is safer and more effective than using first-line antiemetics. Thiamine (vitamin B1) should be introduced following protocols to prevent refeeding syndrome and Wernicke encephalopathy. Recent advances in the genetic study of NVP and HG suggest a placental component to the aetiology by implicating common variants in genes encoding placental proteins (namely GDF15 and IGFBP7) and hormone receptors (namely GFRAL and PGR). New studies on aetiology, diagnosis, management and treatment are under way. In the next decade, progress in these areas may improve maternal quality of life and limit the adverse outcomes associated with HG.

中文翻译：

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妊娠和恶心呕吐的恶心和呕吐。

恶心和妊娠呕吐（NVP）是一种常见病，影响多达70％的孕妇。尽管尚无关于妊娠剧吐（HG）的共识定义，但通常将其视为NVP的严重形式，据报道在0.3-10.8％的孕妇中发生。HG可能与不良的母亲，胎儿和儿童结局有关。可以通过饮食和生活方式的改变来控制大多数NVP的女性，但是超过三分之一的患者会遇到临床相关症状，可能需要补充液体和维生素和/或止吐疗法，例如多西拉敏/吡rid醇联合治疗，不致畸，可能有效治疗NVP。恩丹西酮通常用于治疗HG，但迫切需要进行研究，以确定它是否比使用一线止吐药更安全，更有效。应按照规程引入硫胺素（维生素B1），以防止再进食综合征和Wernicke脑病。NVP和HG的遗传研究的最新进展表明，胎盘成分是病因的一种机制，原因是牵涉编码胎盘蛋白（即GDF15和IGFBP7）和激素受体（即GFRAL和PGR）的基因中的常见变异。关于病因，诊断，治疗和治疗的新研究正在进行中。在接下来的十年中，这些领域的进步可能会改善孕产妇的生活质量并限制与HG相关的不良后果。NVP和HG的遗传研究的最新进展表明，胎盘成分是病因的一种机制，原因是牵涉编码胎盘蛋白（即GDF15和IGFBP7）和激素受体（即GFRAL和PGR）的基因中的常见变异。关于病因，诊断，治疗和治疗的新研究正在进行中。在接下来的十年中，这些领域的进步可能会改善孕产妇的生活质量并限制与HG相关的不良后果。NVP和HG的遗传研究的最新进展表明，胎盘成分是病因的一种机制，原因是牵涉编码胎盘蛋白（即GDF15和IGFBP7）和激素受体（即GFRAL和PGR）的基因中的常见变异。关于病因，诊断，治疗和治疗的新研究正在进行中。在接下来的十年中，这些领域的进步可能会改善孕产妇的生活质量并限制与HG相关的不良后果。