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Gynécologie Obstétrique & Fertilité
Volume 35, n° 6
pages 565-569 (juin 2007)
Doi : 10.1016/j.gyobfe.2007.04.005
Received : 1 December 2006 ;  accepted : 2 April 2007
Approche psychosomatique des vomissements incoercibles du premier trimestre
Psychosomatical approach to Hyperemesis gravidarum
 

J. Cohen a, G. Ducarme a, b, , D. Neuman a, M. Uzan a
a Service de chirurgie gynécologique et d'obstétrique, CHU Jean-Verdier, Assistance publique-Hôpitaux de Paris (APHP), avenue du 14-Juillet, 93140 Bondy, France 
b Service de chirurgie gynécologique et d'obstétrique, hôpital Beaujon, Assistance publique-Hôpitaux de Paris (APHP), Université Paris-VII, 100, boulevard du Général-Leclerc, 92110 Clichy, France 

Auteur correspondant.
Résumé

Les vomissements gravidiques, symptôme physiologique du premier trimestre, sont un motif fréquent de consultation en urgence ainsi que d'hospitalisation dans les formes sévères (Hyperemesis gravidarum ). En dépit de l'aversion habituellement développée à l'encontre des patientes hospitalisées pour H. gravidarum , il est important de comprendre la détresse de ces femmes en proie à un symptôme difficile à supporter qui reflète souvent un conflit psychique vis-à-vis de leur grossesse. Le rôle du gynécologue doit rester celui du médecin somatique qui prend en charge le symptôme et ses conséquences cliniques parfois désastreuses. Celui du psychologue ou du psychiatre est fondamental dans cette pathologie: il va amener la patiente à travailler sur le ressenti de sa grossesse, à inscrire celle-ci dans son histoire personnelle et à comprendre les sentiments contradictoires qu'elle peut éprouver vis-à-vis de cette grossesse.

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Abstract

Vomiting of pregnancy is a physiological symptom of the first trimester and is a frequent reason for consultation in emergency as well as hospitalization in the severe forms (Hyperemesis gravidarum ). Though strong the aversion usually developed against the hospitalized patients for H. gravidarum may be, it is important to understand the distress of these women with a symptom difficult to endure, which often reflects a psychical conflict with respect to their pregnancy. The gynecologist must be the somatic doctor who deals with the symptom and its sometimes disastrous clinical consequences, whereas the psychologist or the psychiatrist plays a fundamental role in this pathology. Indeed, he will lead the patient to work on how she feels her pregnancy, to give it a place in her personal history and to understand her contradictory feelings with regard to this pregnancy.

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Mots clés : Vomissements gravidiques, Hyperemesis gravidarum , Approche psychosomatique

Keywords : Vomiting of pregnancy, Hyperemis gravidarum , Psychosomatical approach




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