Hyperemesis Flashcards
1
Q
Incidence
A
1/1000
2
Q
Risk factors
A
Molar
Multiples
3
Q
Test linked with severity
A
hCG directly linked to severity
4
Q
Symptoms/Signs
A
Persistent and intractable vomiting Weight loss Dehydration Ptyalism Hypovolaemic Electrolytes Behaviour disorders Haematemesis - Mallory-Weiss
5
Q
Maternal complications
A
Liver and renal failure in severe cases
Hyponatraemia and rapidreversal leading to pontine myelination
Thiamine deficiency may lead to Wernicke’s and this may lead to foetal death
6
Q
Ix
A
FBC U&E LFT Pelvic USS MC&S Urine - KETONES
7
Q
Rx
A
Inpatient or outpatient, admit if not tolerating fluids
IV fluids - NO GLUCOSE
Daily U&E
Thiamine
ANTIEMETICS - Promethazine and Cyclizine 1ST LINE
Prochlorperazine or Metaclopramide 2ND LINE
Odansetron 3RD LINE
Consultant managed steroids 4TH LINE - usually requires admission
TOP may be the only option left in intractable HG
