Hyperemesis gravidarum

Question 1

Definition/clinical features

Answer 1

Nausea and vomiting in early pregnancy so severe as to cause severe dehydration, weight loss or electrolyte disturbance
Lots of N+V, signs of dehydration
Seldom persists beyond 14 weeks
More common in multiparous women

Question 2

Management

Answer 2

Exclude UTI, multiple and molar pregnancy as predisposing conditions
IV rehydration
Antiemetics - metoclopramide, cyclizine, ondansetron
Thiamine (prevent neurological complications of vit depletion)
Steroids in severe cases
Psychological support
Termination if too severe