Hyperemesis Gravidarum

Question 1

What is hyperemesis gravidarum?

Answer 1

An extreme form of nausea and vomiting during pregnancy

Question 2

When is hyperemesis most common?

Answer 2

Between 8 and 12 weeks

Question 3

What are the risk factors for hyperemesis?

Answer 3

Increased b-hCG
Molar pregnancy
Nulliparity
Obesity
Family history of NVP
Previous NVP/hyperemesis

Question 4

What is the criteria for admission in a patient with hyperemesis?

Answer 4

Nausea and vomiting and:
- Unable to keep down liquids or oral antiemetics
OR
- Ketonuria
OR
- Weight loss > 5% of pre-pregnancy weight despite treatment with anti-emetics

Question 5

What is the triad of symptoms in hyperemesis?

Answer 5

5% weight loss
Dehydration
Electrolyte imbalance

Question 6

What are the first line anti-emetics for hyperemesis?

Answer 6

Cyclizine - antihistamines

Question 7

What other class of medications can be used in hyperemesis?

Answer 7

Phenothiazines
- Prochlorperazine
- Chlorpromazine

Question 8

What fluid is used for rehydration in hyperemesis?

Answer 8

IV saline with potassium

Question 9

What are the complications of hyperemesis?

Answer 9

Wernicke’s encephalopathy
AKI
VTE
Oesophagitis
Mallory-Weiss tear