American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · May 2002
ReviewThe role of behavioral conditioning in the development of nausea.
Literature related to the prevalence and etiology of anticipatory nausea and vomiting associated with chemotherapy is reviewed. Physiologic causes and psychological factors, including expectations, beliefs, and conditioning, are examined to help explain these phenomena. The efficacy of pharmacologic and behavioral treatments is discussed. Similarities between the experience of anticipatory nausea and vomiting and morning sickness suggest that the conditioning model may be relevant to understanding the development of pregnancy-related nausea.
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Am. J. Obstet. Gynecol. · May 2002
ReviewEvidence-based view of safety and effectiveness of pharmacologic therapy for nausea and vomiting of pregnancy (NVP).
Our goal was to review the safety and effectiveness of available antiemetics for treatment of nausea and vomiting of pregnancy. ⋯ Many medications, particularly H(1)-antagonists and phenothiazines, are safe and effective for treatment of varying degrees of NVP.
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Am. J. Obstet. Gynecol. · May 2002
ReviewPsychological factors in the etiology and treatment of severe nausea and vomiting in pregnancy.
The assumption is frequently made that women with severe nausea and vomiting during pregnancy are transforming psychological distress into physical symptoms. Psychoanalytic theory supporting this assumption is reviewed, along with the few methodologically flawed empirical studies that have been conducted. ⋯ This implies that psychological responses can interact with the physiology of nausea and vomiting during pregnancy to exacerbate the condition. As such, psychological treatments for the symptoms of this disorder need to be further explored.
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Am. J. Obstet. Gynecol. · May 2002
ReviewParacervical block for labor analgesia: a brief historic review.
This historic review was written to clarify the known efficacy and side effects of paracervical blockade for labor analgesia. Although the popularity of the technique has diminished considerably, it continues to be used by some clinicians with ostensibly good results. The Cochrane Controlled Trials Register (CCTR;SR-PREG) and the electronic database MEDLINE were searched for studies reported in English to determine efficacy and side effects of paracervical block. ⋯ Postparacervical block fetal bradycardia is the most significant side effect with a reported incidence ranging from 0% to approximately 40%. Overall, it appears that the incidence of postparacervical block fetal bradycardia is approximately 15%. However, the etiology of the observed fetal bradycardia remains unclear, and the incidence of adverse impact on fetal or neonatal outcome remains uncertain because there are too few trials with too few patients.
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Am. J. Obstet. Gynecol. · May 2002
ReviewUnintended effects of epidural analgesia during labor: a systematic review.
Epidural analgesia is used by more than half of laboring women, yet there is no consensus about what unintended effects it causes. To evaluate the state of our knowledge, we performed a systematic review of the literature examining the unintended maternal, fetal, and neonatal effects of epidural analgesia used for pain relief in labor by low-risk women. Our review included randomized and observational studies appearing in peer review journals since 1980. ⋯ Women should be informed of unintended effects of epidural clearly supported by the evidence, especially since epidural use is almost always an elective procedure. Further research is needed to advance our understanding of the unintended effects of epidural. Improved information would permit women to make truly informed decisions about the use of pain relief during labor.