دورية أكاديمية
Oral rehydration therapy versus intravenous rehydration therapy in the first 12 h following hospitalization for hyperemesis gravidarum: A randomized controlled trial.
| العنوان: | Oral rehydration therapy versus intravenous rehydration therapy in the first 12 h following hospitalization for hyperemesis gravidarum: A randomized controlled trial. |
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| المؤلفون: | Wan Jabarudin WNE; Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia., Narayanan V; Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia., Hamdan M; Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia., Gunasagran Y; Department of Obstetrics and Gynecology, University Malaya Medical Center, Lembah Pantai, Kuala Lumpur, Malaysia., Thavarajan RD; Department of Obstetrics and Gynecology, University Malaya Medical Center, Lembah Pantai, Kuala Lumpur, Malaysia., Kamarudin M; Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia., Tan PC; Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia. |
| المصدر: | International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2024 Jul; Vol. 166 (1), pp. 442-450. Date of Electronic Publication: 2024 Feb 15. |
| نوع المنشور: | Journal Article; Randomized Controlled Trial; Comparative Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley Country of Publication: United States NLM ID: 0210174 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-3479 (Electronic) Linking ISSN: 00207292 NLM ISO Abbreviation: Int J Gynaecol Obstet Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2017- : Malden, MA : Wiley Original Publication: [New York, NY] Hoeber Medical Division, Harper & Row, [c1969- |
| مواضيع طبية MeSH: | Hyperemesis Gravidarum*/therapy , Fluid Therapy*/methods , Hospitalization*/statistics & numerical data, Humans ; Female ; Pregnancy ; Adult ; Infusions, Intravenous ; Treatment Outcome ; Length of Stay/statistics & numerical data ; Patient Satisfaction ; Weight Gain |
| مستخلص: | Objective: To evaluate oral rehydration therapy (ORT) compared with intravenous rehydration therapy (IVT) in the early inpatient management of hyperemesis gravidarum (HG). Methods: A total of 124 women hospitalized for HG from February 10, 2021 till January 6, 2023 were randomized to ORT (n = 61) or IVT (n = 63) for an initial 12 h. Inclusion criteria includes women older than 18 years, with a viable intrauterine pregnancy less than 14 weeks at their first hospitalization for HG with ketonuria of at least 2+. Primary outcomes were (1) satisfaction score with allocated intervention, (2) weight change, and (3) ketonuria change at 12 h. Secondary outcomes included vomiting frequency, nausea score, serial vital signs, hematocrit and electrolyte levels at 12 h, deviation from treatment protocol (cross-over therapy), participant recommendation of allocated treatment to a friend, and length of hospital stay. Results: Primary outcomes of (1) participant satisfaction score (on a 0-10 visual numerical rating scale) was 7 (interquartile range [IQR] 5-8) versus 9 (IQR 8-10), P < 0.001; (2) weight gain was 293 ± 780 g versus 948 ± 758 g, P < 0.001; and (3) ketonuria improvement was 50/61 (82.0%) versus 49/63 (77.8%) (relative risk [RR] 1.05, 95% confidence interval [CI] 0.88-1.26, P = 0.561) for ORT versus IVT, respectively. For secondary outcomes, vomiting frequency was 2.6 ± 2.7 versus 1.1 ± 1.4 episodes (P < 0.001), participant cross-over rate to opposing treatment 20/61 (32.8%) versus 0/63 (0%) (P < 0.001) (in the 12-h study period) and participant recommendation of allocated treatment to a friend rate 24/61 (39.3%) versus 61/63 (96.8%) (RR 0.41, 95% CI 0.30-0.56, P < 0.001) for ORT versus IVT, respectively. By hospital discharge, 31/61 (50.8%) of women allocated to ORT had required IVT. Other secondary outcomes of serial assessments of nausea score and vital signs, hematocrit and electrolyte levels, and length of hospital stay were not different. Conclusions: ORT was inferior to IVT in two primary outcomes and three secondary outcomes. Cross-over rate to intravenous therapy from oral therapy was 50.8% by hospital discharge. Intravenous rehydration therapy should remain as first-line rehydration therapy in the early inpatient treatment of HG. Clinical Trial Registration: The present study was registered in ISRCTN registry on December 6, 2020 with trial identification number: ISRCTN 40152556 (https://doi.org/10.1186/ISRCTN40152556). The first participant was recruited on February 10, 2021. (© 2024 International Federation of Gynecology and Obstetrics.) |
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| معلومات مُعتمدة: | Universiti Malaya |
| فهرسة مساهمة: | Keywords: hyperemesis gravidarum; intravenous rehydration; nausea; oral rehydration; pregnancy; satisfaction; vomiting |
| تواريخ الأحداث: | Date Created: 20240215 Date Completed: 20240626 Latest Revision: 20240626 |
| رمز التحديث: | 20240626 |
| DOI: | 10.1002/ijgo.15429 |
| PMID: | 38358264 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1879-3479 |
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| DOI: | 10.1002/ijgo.15429 |