Hyperemesis Gravidarum

Question 1

What are the symptoms of hyperemesis gravidarum

Answer 1

Persistent vomiting
Acute starvation
Weight loss

Question 2

Hyperemesis gravidarum is common in

Answer 2

First pregnancy
is multiple gestations
molar pregnancies

Question 3

What is seen in the lab reports of hyperemesis gravidarum

Answer 3

Increase BHCG
increase estradiol

Question 4

What is seen in the history and physical examination of the patient with hyperemesis gravidarum

Answer 4

Morning sickness with acid reflux gastroenteritis hyperthyroidism and neurological conditions

Question 5

How to diagnose hyperemesis gravidarum

Answer 5

First rule out molar pregnancy by checking beta hCG level and ultrasound
Second determine the severity by evaluating for ketonemia , ketouria , hyponatremia,hypokalemia, hypochloremic metabolic alkalosis. Measure liver enzymes, serum bilirubin, serum amylase / lipase 

Question 6

What is the treatment for hyper emesis gravidarum

Answer 6

1) administer vitamin B6
2) doxylamine ( antihistamine) PO
3) promethazine or dimenhydrinate PO/PR
If severe , metoclopramide , ondansetron , prochlorperazine , promethazine IM
If dehydrated: IV fluids , IV nutrition , dimenhydrinate IV