hyperemesis gravidarum Flashcards
what is hyperemesis gravidarum defined as
excessive/persistent vomiting in pregnant woman which leads to ketosis and >5% weight loss
complications
wernicke’s encephalopathy
death
SGA
electrolyte disturbance in hyperemesis gravidarum
hyponatraemia
hypocalcaemia
low serum urea
clinical presentation
unable to keep food/fluid down
weight loss
dehydration - dry mucous membrane, postural htn
become ketotic
blood test abnormalities
high heamatocrit
abnormal LFTs - raised bilirubin, raised AST, ALT
hyperthyroid: high T4, low TSH
why do we do MSSU
there may be underlying UTI predisposing/exacerbating nausea and vomiting
why do we do urine dipstix
proteinuria
ketones
specific gravity - dehydration
why do USS
rule out multiple pregnancy and mole
management
rehydration IV fluid - normal saline
anti-emetics
antacids
thyamine
common anti-emetics used
cyclizine
phenothiazine
what to do if N&V >3 days
change antiemetic
prescribe ranitidine if reflux
vitamin injections
steroids
when to consider NG feeding
weight loss >10%
