Hyperemesis gravidarum Flashcards
Define hyperemesis gravidarum.
Excessive vomiting in early pregnancy associated with ketosis and dehydration.
Explain the aetiology of hyperemesis gravidarum.
Poorly understood but associated with BHCG levels.
What are the risk factors for hyperemesis gravidarum?
Multiple pregnancy, GTD, previous HG, high BMI, nulliparity, low maternal age, hyperthyorid
Summarise the epidemiology of hyperemesis gravidarum.
1% pregnant women.
Recognise the presenting symptoms of hyperemesis gravidarum.
Severe N&V
Anorexia
Weight loss
Recognise the signs of hyperemesis gravidarum on physical examination.
Dehydration
Tachycardia
Hypotension
Dry mucous membranes.
Identify appropriate investigations for hyperemesis gravidarum and interpret the results.
Utine: Assess ketosis, exclude UTI
Bloods: FBC, BHCG, U&Es, LFT, TFT.
USS to exclude multiple and GTD.
Generate a management plan for hyperemesis gravidarum.
Admit, rehydrate with IV saline or Hartmann’s. NOT dextrose.
PO thiamine, consider thromboprophylaxis.
Severe – prednigolone, total parenteral nutrition.
Identify the possible complications of hyperemesis gravidarum and its management. Summarise the prognosis for patients with hyperemesis gravidarum.
MW tears, Wernickes encephalopathy from loss of B1, muscle wasting, VTE from dehydration, electrolyte disturbance, renal impairment.
Good prognosis with treatment.