8) Early Toxicosis Flashcards
What’s the definition of “Toxicosis”?
- It’s poisoning by harmful substance
- Which is formed by fetal development
EARLY = Occurs BEFORE 12 Gestational Weeks!, or during 1st Trimester
LATE
- Presents with Chronic HTN - MORE than 140/90
- Presents with Gestational HTN, means NO Proteinuria
- Presents with Preeclampsia
What are the Causes / Risk Factors which contribute to Early Toxicosis?
- INCREASED Levels of hCG - indicate Transient Hyperthyroidism
- An early pregnancy - primigravida (Less than 17 yo)
- Multiple Gestations
- Chronic Hypertension, Diabetes, GI Disorders, Obesity
- Family Hx of EPH Complex - Edema, Proteinuria, and Hypertension
What are the Frequent Forms of Early Toxicosis?
1) Ptyalism - Excess Saliva
2) Nausea / Emesis - Degrees be Mild, Moderate or Severe (Hyperemesis Gravidarum)
Explain the Degrees of Vomiting
1) MILD - Occurs 2-4x Day, after eating
2) MODERATE - Occurs 5-10x Day, at any time
- Along with weight loss, ketosis, dehydration + fatigue
3) HYPEREMESIS GRAVIDARUM (SEVERE) - Due to INCREASED Levels of hCG
Describe Hyperemesis Gravidarum
- Vomiting occurs 20-25x Day - NOT associated with meals
- Results of increased hCG levels
Risk Factors
- Nullparous (NEW)
- Have HIGH BMI
CFs
- NB! Weight Loss is an indicator in DIAGNOSTICS
- Dry Skin, Reduced Skin Tugor, Cool + pale extremities
- hypotensive
- Ketones in Urine
What are the Complications of Hyperemesis Gravidarum?
MATERNAL
- Liver + Renal Failure
- Hyponatremia
- Thiamine Deficiency
FETAL
- Growth Restrictions
- Wernicke’s Encephalopathy –> Fetal Death
What is the DIFFERENCE BETWEEN Morning Sickness and Hyperemesis Gravidarum?
- Morning Sickness = Due to increased levels of Oestrogen Levels
- Hyperemesis Gravidarum = Due to increased levels of hCG Levels
What is the Diagnosis and Treatment?
DIAGNOSIS
- Urinalysis
- Glucose
- Urea and Electrolytes
- ABG
- LFTs
TREATMENT
- antiemetics - cyclizine
- IV Fluids (Saline)
- Thiamine B1 - to prevent Wernicke’s Encephalopathy
- Heparin
