Hyperemesis Gravidarum

Question 1

Symptoms

Answer 1

**typically begin between 3 and 5 weeks of pregnancy and 80% resolve by 20 weeks gestation

**dehydration, ketonuria, hypokalemia , weight loss of > 5%

Question 2

Risk Factors

Answer 2

*Hydatidiform mole
*Multifetal Gestation
*History of HG

Question 3

Complications

Answer 3

*metabolic alkalosis ,hypokalemia
*Wernicke’s encephalopathy (b1 def..)
*acute tubular necrosis
*Mallory-Weiss tear of the esophagus (from vomiting )
*Pneumomediastinum
*splenic avulsion
*depression and anxiety.

Question 4

Treatment

Answer 4

Mild presentation supportive :hydration and vitamin supplementation, such as vitamin B6(pyridoxine), 10-30 mg for up to 4 times daily.. Then, if symptoms continue after 48 hours, antiemetics such as Doxylamine, Promethazine, or Dimenhydrinate.

2-For persistent syMPToms, with or without dehydration, Prochlorperazine, Metoclopramide, or Trimethobenzamide.
MPT(mnemonic )

3-For patients presenting with dehydration or weight loss, Thiamine, and Ondansetron or Methylprednisolone (MOT)

4-For patients unable to maintain weight, total enteral or parenteral nutrition.