example, NVP in early pregnancy was

example, NVP in early pregnancy was thought to be a mechanism to trigger awareness of pregnancy to the partner resulting in behaviour modification for protection and alerting the need for increased food supplies.42 These authors also proposed the notion of NVP as a mechanism for avoidance or purging of foods that may place the mother or foetus at risk. Caffeine and meat products are most cited to be adverse in pregnancy, with many women identifying the odours as a trigger for nausea.43
Metabolic control in pregnancy
Studies on NVP and HG in anorexic pregnant women are not clear since this can be super-imposed on anorexic behaviours but Magee et al, noted the importance of excluding anorexia in NVP.44 There are correlations between nausea and vomiting in hypoglycaemia and studies have shown that children presenting with hypoglycaemia also experience vomiting and following surgery, dexamethasone, which increases blood glucose level to mitigate nausea and vomiting can be administered.45,46 NVP inevitably influences calorie intake with low calories decreasing insulin. Women with low BMI experience fewer symptoms of morning sickness.16 The mechanism underlying the reduction in nausea and vomiting in women with low BMI is reduced production of placental hCG and thyroxine as a result of reduced maternal insulin levels.
Figure 1, illustrates how psychological stress may exacerbate NVP and steroids are involved but the use of hydrocortisone and methylprednisolone on successful cessation of HG is not clear.8,29 The antiemetic properties of corticosteroid are possibly due to various factors acting in concert or individually and prostaglandin antagonism,47 stimulation of endorphins that elevate mood and appetite stimulation and reduction in tryptophan in neural tissue have been suggested.48,49
It can be postulated that in pregnancy, disturbances in metabolic control and increased requirements for glucose give rise to mild hypoglycaemia and during these situations, such as following overnight fasting; hypoglycaemia may trigger nausea and vomiting. The relationships between glycaemia and NVP and HG are not clear hence studies need to be carried out to assess glycaemia during NVP and HG as well as during periods that the women are not experiencing these conditions.
Significance of finding biomarkers for nausea and vomiting in pregnancy and hyperemesis gravidarum
It is important to understand the causes or mitigating factors for NVP and HG and possibly find biomarkers to predict or to monitor since the effects of NVP and HG are far reaching causing financial and social burdens. Glucose and hormonal measurements are within the capabilities of most laboratories and oxidative stress markers can also be measured and such assays need further studying especially their association and/or correlation with NVP and HG. Studies show that oxidative stress contributes to pathogenesis of various diseases including respiratory diseases and its contribution to NVP and HG needs research as well as the mitigation of anti-oxidants.50-52 These conditions affect the mother and the foetus and can lead to complications such as maternal and foetal morbidity, vitamin deficiencies, low birth weights as well as having psychological impacts, hence there is need for early identification and intervention.5,11,12 In a study on impact of NVP and daily functioning in pregnant women, O’Brien and Naber, reported that 83% responded that NVP affected their ability to perform normal daily activities and 34% of these had to change their daily schedules due to NVP.3 These are salient loss in productivity in everyday life, which translates to economic value. CONCLUSIONS
NVP and HG affect maternal and foetal wellbeing but aetiology of these disorders is not clear and there is a case for hormonal cause, particularly hCG and oestrogen. NVP and HG perhaps have different control mechanisms with NVP possibly being an adjustment to a variety of hormonal changes that resolves when placental control commences while HG may be a consequence in individuals less tolerant to hormone changes. More studies on genetics are needed to elucidate familial and foetal influences. Other areas requiring studies are the roles of oxidative stress, vitamin deficiencies and importantly the role of glycaemic status as triggers of NVP episodes and also the potential role of insulin as a trigger. The complex relationship between NVP and influencing factors such as calorie intake/BMI, energy requirements, insulin and hCG requires further exploration. Whilst management options for NVP and HG are available, these have not been elaborated on in this review. Various antiemetic options and natural remedies are available to alleviate nausea and vomiting. Consideration must be given to maternal mental health as the effects of NVP and HG go beyond physical manifestation and influence the woman’s ability to participate in daily routines and social interactions.
Funding: No funding sources
Conflict of int

Hasil (Bahasa Indonesia) 1:

contoh, NVP di awal kehamilan diperkirakan menjadi mekanisme untuk memicu kesadaran kehamilan mitra mengakibatkan modifikasi perilaku untuk perlindungan dan memperingatkan perlunya peningkatan makanan supplies.42 penulis ini juga mengusulkan gagasan NVP sebagai mekanisme untuk menghindari atau membersihkan makanan yang dapat menempatkan ibu atau janin beresiko. Produk kafein dan daging yang paling dikutip akan merugikan dalam kehamilan, dengan banyak perempuan yang mengidentifikasi bau sebagai pemicu untuk nausea.43Kontrol metabolik di kehamilanStudi pada NVP dan HG di anoreksia ibu hamil tidak jelas karena hal ini dapat tergabung perilaku anoreksia tapi Magee et al, dicatat pentingnya termasuk anoreksia pada NVP.44 ada korelasi antara mual dan muntah hypoglycaemia dan studi-studi telah menunjukkan bahwa anak-anak yang menyajikan dengan hypoglycaemia juga mengalami muntah dan setelah operasi, deksametason, yang meningkatkan kadar glukosa darah untuk mengurangi mual dan muntah dapat administered.45 , 46 NVP pasti mempengaruhi asupan kalori dengan kalori rendah yang mengurangi insulin. Wanita dengan rendah BMI mengalami gejala yang lebih sedikit pagi sickness.16 mekanisme yang mendasari pengurangan mual dan muntah pada wanita dengan rendah BMI mengurangi produksi bolus hCG dan tiroksin sebagai akibat dari tingkat insulin ibu berkurang.Figure 1, illustrates how psychological stress may exacerbate NVP and steroids are involved but the use of hydrocortisone and methylprednisolone on successful cessation of HG is not clear.8,29 The antiemetic properties of corticosteroid are possibly due to various factors acting in concert or individually and prostaglandin antagonism,47 stimulation of endorphins that elevate mood and appetite stimulation and reduction in tryptophan in neural tissue have been suggested.48,49It can be postulated that in pregnancy, disturbances in metabolic control and increased requirements for glucose give rise to mild hypoglycaemia and during these situations, such as following overnight fasting; hypoglycaemia may trigger nausea and vomiting. The relationships between glycaemia and NVP and HG are not clear hence studies need to be carried out to assess glycaemia during NVP and HG as well as during periods that the women are not experiencing these conditions.Significance of finding biomarkers for nausea and vomiting in pregnancy and hyperemesis gravidarumIt is important to understand the causes or mitigating factors for NVP and HG and possibly find biomarkers to predict or to monitor since the effects of NVP and HG are far reaching causing financial and social burdens. Glucose and hormonal measurements are within the capabilities of most laboratories and oxidative stress markers can also be measured and such assays need further studying especially their association and/or correlation with NVP and HG. Studies show that oxidative stress contributes to pathogenesis of various diseases including respiratory diseases and its contribution to NVP and HG needs research as well as the mitigation of anti-oxidants.50-52 These conditions affect the mother and the foetus and can lead to complications such as maternal and foetal morbidity, vitamin deficiencies, low birth weights as well as having psychological impacts, hence there is need for early identification and intervention.5,11,12 In a study on impact of NVP and daily functioning in pregnant women, O’Brien and Naber, reported that 83% responded that NVP affected their ability to perform normal daily activities and 34% of these had to change their daily schedules due to NVP.3 These are salient loss in productivity in everyday life, which translates to economic value. CONCLUSIONSNVP and HG affect maternal and foetal wellbeing but aetiology of these disorders is not clear and there is a case for hormonal cause, particularly hCG and oestrogen. NVP and HG perhaps have different control mechanisms with NVP possibly being an adjustment to a variety of hormonal changes that resolves when placental control commences while HG may be a consequence in individuals less tolerant to hormone changes. More studies on genetics are needed to elucidate familial and foetal influences. Other areas requiring studies are the roles of oxidative stress, vitamin deficiencies and importantly the role of glycaemic status as triggers of NVP episodes and also the potential role of insulin as a trigger. The complex relationship between NVP and influencing factors such as calorie intake/BMI, energy requirements, insulin and hCG requires further exploration. Whilst management options for NVP and HG are available, these have not been elaborated on in this review. Various antiemetic options and natural remedies are available to alleviate nausea and vomiting. Consideration must be given to maternal mental health as the effects of NVP and HG go beyond physical manifestation and influence the woman’s ability to participate in daily routines and social interactions.Funding: No funding sourcesConflict of int

Hasil (Bahasa Indonesia) 2:

Misalnya, NVP pada awal kehamilan dianggap mekanisme untuk memicu kesadaran kehamilan pada pasangan yang mengakibatkan modifikasi perilaku untuk perlindungan dan mengingatkan kebutuhan untuk meningkatkan makanan supplies.42 penulis ini juga mengusulkan gagasan NVP sebagai mekanisme untuk menghindari atau membersihkan makanan yang dapat menempatkan ibu atau janin beresiko. Kafein dan produk daging yang paling dikutip menjadi merugikan pada kehamilan, dengan banyak perempuan mengidentifikasi bau sebagai pemicu untuk nausea.43
kontrol metabolik pada kehamilan
Studi pada NVP dan HG pada wanita hamil anoreksia tidak jelas karena ini bisa menjadi super-dikenakan pada perilaku anoreksia tapi Magee et al, mencatat pentingnya termasuk anoreksia di NVP.44 Ada korelasi antara mual dan muntah pada hipoglikemia dan penelitian telah menunjukkan bahwa anak-anak yang mengalami hipoglikemia juga mengalami muntah-muntah dan setelah operasi, deksametason, yang meningkatkan kadar glukosa darah mengurangi mual dan muntah dapat administered.45,46 NVP pasti mempengaruhi asupan kalori dengan kalori rendah menurun insulin. Wanita dengan gejala BMI pengalaman rendah sedikit dari pagi sickness.16 Mekanisme yang mendasari pengurangan mual dan muntah pada wanita dengan BMI yang rendah berkurang produksi hCG plasenta dan tiroksin sebagai akibat dari berkurangnya kadar insulin ibu.
Gambar 1, menggambarkan stres bagaimana psikologis dapat memperburuk NVP dan steroid yang terlibat tetapi penggunaan hidrokortison dan methylprednisolone tentang penghentian sukses HG tidak clear.8,29 sifat antiemetik dari kortikosteroid yang mungkin karena berbagai faktor bertindak dalam konser atau secara individu dan prostaglandin antagonisme, 47 stimulasi endorfin yang mengangkat suasana hati dan stimulasi nafsu makan dan penurunan triptofan dalam jaringan saraf telah suggested.48,49
Hal ini dapat mendalilkan bahwa pada kehamilan, gangguan pada kontrol metabolik dan peningkatan persyaratan untuk glukosa menimbulkan hipoglikemia ringan dan selama situasi ini, seperti berikut puasa semalam; hipoglikemia dapat memicu mual dan muntah. Hubungan antara glikemia dan NVP dan HG tidak jelas maka penelitian perlu dilakukan untuk menilai glikemia selama NVP dan HG serta selama periode bahwa wanita tidak mengalami kondisi ini.
Signifikansi menemukan biomarker untuk mual dan muntah dalam kehamilan dan hiperemesis gravidarum
Hal ini penting untuk memahami penyebab atau faktor mitigasi untuk NVP dan HG dan mungkin menemukan biomarker untuk memprediksi atau untuk memantau sejak efek NVP dan HG yang jauh mencapai menyebabkan beban keuangan dan sosial. Glukosa dan pengukuran hormon berada dalam kemampuan kebanyakan laboratorium dan penanda stres oksidatif juga dapat diukur dan tes seperti perlu lebih belajar terutama asosiasi dan / atau korelasinya dengan NVP dan HG. Studi menunjukkan bahwa stres oksidatif berkontribusi terhadap patogenesis berbagai penyakit termasuk penyakit pernapasan dan kontribusinya terhadap NVP dan HG perlu penelitian serta mitigasi anti-oxidants.50-52 Kondisi ini mempengaruhi ibu dan janin dan dapat menyebabkan komplikasi seperti sebagai morbiditas ibu dan janin, kekurangan vitamin, berat badan lahir rendah serta memiliki dampak psikologis, maka perlu adanya identifikasi awal dan intervention.5,11,12 dalam studi tentang dampak NVP dan fungsi sehari-hari pada wanita hamil, O ' Brien dan Naber, melaporkan bahwa 83% menjawab bahwa NVP mempengaruhi kemampuan mereka untuk melakukan aktivitas normal sehari-hari dan 34% dari ini harus mengubah jadwal sehari-hari mereka karena NVP.3 ini adalah hilangnya menonjol dalam produktivitas dalam kehidupan sehari-hari, yang berarti nilai ekonomi . KESIMPULAN
NVP dan HG mempengaruhi kesejahteraan ibu dan janin tetapi etiologi gangguan ini tidak jelas dan ada kasus untuk penyebab hormonal, terutama hCG dan estrogen. NVP dan HG mungkin memiliki mekanisme kontrol yang berbeda dengan NVP mungkin menjadi penyesuaian berbagai perubahan hormonal yang dapat memecahkan ketika kontrol plasenta dimulai saat HG mungkin akibat pada individu yang kurang toleran terhadap perubahan hormon. Studi lebih lanjut tentang genetika diperlukan untuk menjelaskan pengaruh keluarga dan janin. Daerah lain yang membutuhkan penelitian adalah peran stres oksidatif, kekurangan vitamin dan penting peran status glikemik sebagai pemicu dari episode NVP dan juga potensi peran insulin sebagai pemicu. Hubungan yang kompleks antara NVP dan mempengaruhi faktor-faktor seperti asupan kalori / BMI, kebutuhan energi, insulin dan hCG membutuhkan eksplorasi lebih lanjut. Sementara pilihan manajemen untuk NVP dan HG tersedia, ini belum diuraikan di dalam ulasan ini. Berbagai pilihan antiemetik dan solusi alami yang tersedia untuk meringankan mual dan muntah. Pertimbangan harus diberikan untuk kesehatan mental ibu sebagai efek dari NVP dan HG melampaui manifestasi fisik dan mempengaruhi kemampuan wanita untuk berpartisipasi dalam rutinitas sehari-hari dan interaksi sosial.
Pendanaan: Tidak ada sumber pendanaan
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