Hyperemesis gravidarum Flashcards
1
Q
HG - def
A
Excessive pregnancy-related N/V that prevents adequate food and fluid intake and is associated with weight loss >5% of body mass
2
Q
HG - def
A
Excessive pregnancy-related N/V that prevents adequate food and fluid intake and is associated with weight loss >5% of body mass
3
Q
HG - symptoms
A
- Persistent and intractable vomiting (inability to keep food or fluid down)
- Constant and distressive spitting due to excessive salivation (ptyalism)
- Dizziness when standing
- Listlessness (severe hyponatraemia)
- Seizures (severe hyponatraemia) - rare
4
Q
HG - symptoms
A
- Persistent and intractable vomiting (inability to keep food or fluid down)
- Thirst
- Dizziness when standing
- Listlessness (severe hyponatraemia)
- Seizures (severe hyponatraemia) - rare
5
Q
HG - epi
A
6
Q
HG - ix
A
- Urine dipstick - ketones, specific gravity
- MSU - exclude UTI
- FBE - increased haematocrit
- UEC - hyponatraemia, hypokalaemia, hypochloraemia
- TFTs if clinical signs of hyperthyroidism (HCG cross-reactivity with TSH -> HG associated with elevated T4)
7
Q
HG - signs
A
- Weight loss
- Dehydration
- Muscle wasting
8
Q
HG - dx
A
- Clinical dx
2. Exclude other causes of vomiting - UTI, gastro, appendicitis, biliary tract disease, Addison’s disease
9
Q
HG - ix
A
- Urine dipstick - ketones, specific gravity
- MSU - exclude UTI
- FBE - increased haematocrit
- UEC - hyponatraemia, hypokalaemia, hypochloraemia
- TFTs if clinical signs of hyperthyroidism (HCG cross-reactivity with TSH -> HG associated with elevated T4)
10
Q
HG - mx
A
- Usually resolves spontaneously by 16 weeks
- Supportive care - correction of fluid and electrolyte imbalances, and nutritional/vitamin deficiencies
- Less severe HG - outpt mx
- Severe cases - hospitalisation
- IV rehydration with NS/Hartmann’s + KCl, plus vitamin supplementation
