Digestive Diseases and Sciences

, Volume 35, Issue 8, pp 961–968 | Cite as

Gastric dysrhythmias and nausea of pregnancy

  • K. L. Koch
  • R. M. Stern
  • M. Vasey
  • J. J. Botti
  • G. W. Creasy
  • A. Dwyer
Original Articles


Gastric dysrhythmias have been recorded from patients with a variety of nausea syndromes. The aim of this study was to measure gastric myoelectric activity in women with and without nausea during the first trimester of pregnancy. In 32 pregnant women gastric myoelectric activity was recorded for 30–45 min with cutaneous electrodes that yielded electrogastrograms (EGGs). Frequencies of the EGG waves were analyzed visually and by computer. Subjects rated their nausea at the time of EGG recording on a visual analog scale with 0 representing no nausea and 300 mm severe nausea. Gastric dysrhythmias were found in 26 pregnant subjects: Seventeen had tachygastrias (EGG frequencies of 4–9 cpm),five had 1- to 2-cpm EGG waves, and four had flat-line patterns. Mean nausea scores of the subjects with tachygastrias, 1- to 2-cpm, and flat-line patterns were 64.8±13, 93.4±23, and 77.2±36, respectively. Six pregnant subjects had normal 3-cpm EGG patterns, and their nausea scores averaged 2.8±1.1 (P<0.05 compared with nausea scores in subjects with tachygastrias, 1- to 2-cpm, and flat-line rhythms). Six subjects with gastric dysrhythmias during pregnancy were restudied after delivery; each of these subjects had normal 3-cpm EGG patterns and none had nausea. Thus, gastric dysrhythmias are objective pathophysiologic events associated with symptoms of nausea reported during the first trimester of pregnancy.

Key words

electrogastrography pregnancy vomiting spectral analysis 


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  1. 1.
    Fairweather DVI: Nausea and vomiting in pregnancy. Am J Obstet Gyncol 102:135–174, 1968Google Scholar
  2. 2.
    Klebanoff MA, Koslowe PA, Kaslow R, Rhoads GC: Epidemiology of vomiting in early pregnancy. Obstet Gynecol 66:612–616, 1985PubMedGoogle Scholar
  3. 3.
    Tierson FD, Olsen CL, Hook EB: Nausea and vomiting of pregnancy and association with pregnancy outcome. Am J Obstet Gynecol 155:1017–1022, 1986PubMedGoogle Scholar
  4. 4.
    Ryan JP, Bhojwani A, Wang MB: Effect of pregnancy on gastric motilityin vivo andin vitro in the guinea pig. Gastroenterology 93:29–34, 1987PubMedGoogle Scholar
  5. 5.
    Davison JS, Davison MC, Hay DM: Gastric emptying time in late pregnancy and labour. J Obstet Gynecol 77:37–41, 1970Google Scholar
  6. 6.
    Hunt JN, Murray FA: Gastric function in pregnancy. J Obstet Gynecol Br Emp 65:78–83, 1958Google Scholar
  7. 7.
    Hinder RA, Kelly KA: Human gastric pacesetter potential. Site of origin, spread and response to gastric transection and proximal gastric vagotomy. Am J Surgery 133:29–33, 1978Google Scholar
  8. 8.
    Meyer JE: Motility of the stomach and gastroduodenal junction.In Physiology of the Gastrointestinal Tract. LR Johnson (ed). New York, Raven Press, 1987, pp 613–629Google Scholar
  9. 9.
    You CH, Lee KY, Chey WY, Menguy R: Electrogastrographic study of patients with unexplained nausea, bloating and vomiting. Gastroenterology 79:311–314, 1980PubMedGoogle Scholar
  10. 10.
    You CH, Lee KY, Chey WY: Gastric electromyography in normal and abnormal states in humans.In Functional Disorders of the Digestive Tract. WY Chey (ed). New York, Raven Press, 1983, pp 167–173Google Scholar
  11. 11.
    Brown BH, Smallwood RH, Duthie HL, Stoddard CJ: Intestinal smooth muscle electrical potentials recorded from surface electrodes. Med Biol Eng 13:97–103, 1975PubMedGoogle Scholar
  12. 12.
    Geldof H, van der Schee EJ, van Blankenstein M, Grashuis JL: Electrogastrographic study of gastric myoelectrical activity in patients with unexplained nausea and vomiting. Gut 27:799–808, 1986PubMedGoogle Scholar
  13. 13.
    Abell TL, Malagelada J-R, Lucas AR, Brown ML, Camilleri M, Go VLW, Azpiroz F, Callaway CW, Kao PC, Zinsmeister AR, Huse DM: Gastric electromechanical and neurohormonal function in anorexia nervosa. Gastroenterology 93:958–965, 1987PubMedGoogle Scholar
  14. 14.
    Koch KL, Stern RM, Stewart WR, Dwyer AE. Effect of long-term domperidone therapy on gastric electromechanical activity in symptomatic patients with diabetic gastroparesis. Am J Gastroenterol 84:1069–1075, 1989PubMedGoogle Scholar
  15. 15.
    Stern RM, Koch KL, Leibowitz HW, Lindblad MS, Shupert CL, Stewart WR: Tachygastria and motion sickness. Aviat Space Environ Med 56:1074–1077, 1985PubMedGoogle Scholar
  16. 16.
    Stern RM, Koch KL, Stewart WR, Lindblad IM: Spectral analysis of tachygastria recorded during motion sickness. Gastroenterology 92:92–97, 1987PubMedGoogle Scholar
  17. 17.
    Alvarez WC: New methods of studying gastric peristalsis. JAMA 79:1281–1284, 1922Google Scholar
  18. 18.
    Abell TL, Malagelada JR: Glucagon-evoked gastric dysrhythmias in humans shown by an improved electrogastrographic technique. Gastroenterology 88:1932–1940, 1985PubMedGoogle Scholar
  19. 19.
    Hamilton JW, Bellahsene BE, Reichelderfer M, Webster JH, Bass P: Human electrogastrograms. Comparison of surface and mucosal recordings. Dig Dis Sci 31:33–39, 1986PubMedGoogle Scholar
  20. 20.
    van der Schee EJ, Grashuis JL: Contraction-related, lowfrequency components in canine electrogastrographic signals. Am J Physiol 245:G470-G475, 1983PubMedGoogle Scholar
  21. 21.
    Azpiroz F, Malagelada J-R: Pressure activity patterns in the canine proximal stomach: Response to distention. Am J Physiol 247:G265-G272, 1984PubMedGoogle Scholar
  22. 22.
    McCoy EJ, Bass P: Chronic electrical activity of gastroduodenal area: Effects of food and certain catecholamines. Am J Physiol 205:439–445, 1963PubMedGoogle Scholar
  23. 23.
    Kim CH, Zinsmeister AR, Malagelada J-R: Mechanisms of canine gastric dysrhythmia. Gastroenterology 92:993–999, 1987PubMedGoogle Scholar
  24. 24.
    Hornnes PJ: Gastroentero-pancreatic hormones in pregnancy. Scand J Gastroenterol 19:451–456, 1984PubMedGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1990

Authors and Affiliations

  • K. L. Koch
    • 1
  • R. M. Stern
    • 1
  • M. Vasey
    • 1
  • J. J. Botti
    • 1
  • G. W. Creasy
    • 1
  • A. Dwyer
    • 1
  1. 1.Departments of Medicine, Obstetrics and Gynecology, and PsychologyThe Pennsylvania State UniversityHershey and University Park

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