Hyperemesis Gravidarum Flashcards
1
Q
what is this?
A
severe N&V in pregnancy
2
Q
when does N&V peak?
A
in 1st trimester, between 8-12weeks
3
Q
assoc with?
A
high bHCG levels, therefore higher risk w/ multiple gestation and molar pregnancy
4
Q
criteria for diagnosis?
A
- >5% weight loss (compared to pre-pregnancy)
- dehydration
- electrolyte imbalance
5
Q
what might you find on investigation of such pts?
A
elevated serum thyroxine concentration, because bHCG has a similar chemical structure to TSH & therefore acts as a thyroid stimulator
6
Q
Mx?
A
inpatient or outpatient depending on severity
mild: conservative / oral anti emetics (prochlorperazine safest)
severe:
- IV antiemetics
- IV fluids
- thiamine
- corticosteroids if anti-emetics have not worked- only give after fluids tho
- thromboprophylaxis
- may require TPN
7
Q
what other therapies do RCOG recommend?
A
- ginger
- acupressure on wrist
- acupuncture
8
Q
when should admission be considered?
A
- unable to tolerate oral anti-emetics
- electrolye imbalance
- ketones present in urine
9
Q
prognosis?
A
usually improves by 12 weeks gestation as bHCG falls
