The incidence of postoperative nausea and vomiting after caesarean section in patients with hyperemesis gravidarum: a retrospective cohort study |
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| Affiliation: | 1. Department of Anaesthesia, Mater Health Services, South Brisbane, QLD, Australia;2. Department of Anaesthesia, Redland Hospital, Cleveland, QLD, Australia;3. Statistics Unit, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia;4. Mater Research Institute, University of Queensland, Brisbane, QLD, Australia;5. Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa;1. Children''s Health Services Research, Indianapolis, Ind;2. Pediatric and Adolescent Comparative Effectiveness Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Ind;3. Regenstrief Institute Inc, Indianapolis, Ind;1. Department of anaesthesiology and obstetric critical care unit, university maternity hospital of Nancy, 10, avenue du Dr Heydenreich, 54000 Nancy, France;2. Medical intensive care unit, university hospital of Nancy, 54511 Vandœuvre-lès-Nancy, France;1. QIMR Berghofer Medical Research Institute, 300 Herston Rd, Herston, Brisbane, QLD 4006, Australia;2. Infectious Diseases Unit, Royal Brisbane and Womens'' Hospital, Herston, Brisbane, QLD 4029, Australia;3. The University of Queensland, Centre for Clinical Research, Herston, Brisbane, QLD 4006, Australia;4. Central Microbiology, Pathology Queensland, Royal Brisbane and Women''s Hospital, Herston, Brisbane, QLD 4029, Australia;5. The University of Queensland, School of Public Health, Brisbane, QLD 4006, Australia;6. Queensland University of Technology, School of Nursing, Kelvin Grove, Brisbane, QLD 4059, Australia;1. Department of Anesthesia, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India;2. Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada;3. Department of Anesthesia and Perioperative Medicine, Victoria Hospital, London Health Sciences Centre, London, Ontario, Canada;4. Department of Anesthesia and Perioperative Medicine and Department of Epidemiology and Biostatistics, London Health Sciences Centre, University Hospital, London, Ontario, Canada;1. Department of Anesthesiology, Michigan Medicine, 1500 E Medical Center Dr, MI, USA;2. Department of Obstetrics and Gynecology, Michigan Medicine, 1500 E Medical Center Dr, MI, USA;3. Department of Psychiatry, Michigan Medicine, 1500 E Medical Center Dr, MI, USA;4. Department of Family Medicine, Michigan Medicine, 1500 E Medical Center Dr, MI, USA;5. U-M for Healthcare Policy and Innovation, 2800 Plymouth Road, North Campus Research Complex, Building 16, MI, USA |
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| Abstract: | BackgroundPostoperative nausea and vomiting is one of the most common anaesthetic complications of caesarean section. This study examined the association between hyperemesis gravidarum during pregnancy and nausea and vomiting after caesarean section.MethodsA single-centre, retrospective cohort study, using electronic databases of patients with and without hyperemesis gravidarum, undergoing caesarean section from 2015 to 2019. The incidence and severity of postoperative nausea and vomiting were established by a review of the documentation of administration of postoperative anti-emetics within the 24-h period after surgery, and examined using univariable, multivariable binary and ordered logistic regression models.ResultsData were compared for 76 patients with hyperemesis gravidarum and 315 patients without the condition. The incidence of postoperative nausea and vomiting in the hyperemesis group versus the non-hyperemesis group was 43.4% vs 29.6%, respectively. The odds of experiencing postoperative nausea and vomiting was 1.95 times higher in women with hyperemesis gravidarum than in those without (aOR 1.95, 95% CI 1.13 to 3.36, P=0.016). The odds of having more severe postoperative nausea and vomiting were greater in the hyperemesis gravidarum group (aOR 1.91, 95% CI 1.14 to 3.20, P=0.014).ConclusionPatients with hyperemesis gravidarum are more likely to develop nausea and vomiting after caesarean section, and this is likely to be of greater severity than in those without the condition. This finding should assist the effective provision of intra-operative and postoperative anti-emetics for patients with hyperemesis gravidarum undergoing caesarean section. |
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| Keywords: | Postoperative nausea and vomiting Caesarean section Hyperemesis gravidarum |
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