Hyperemesis gravidarum

Question 1

what is first line treatment for hyperemesis gravid arum?

Answer 1

Antihistamine - Promethazine

or

Antiemetic - Clopromazine

Question 2

what is the diagnostic criteria for hyperemesis gravidarum?

Answer 2

prepregnancy weight loss > 5%
dehydration
electrolyte abnormalities

Question 3

what are the NICE guidelines for referral for nausea and vomiting in pregnancy?

Answer 3

continued nausea and vomiting and unable to keep down oral or liquid antiemetics

continued nausea and vomiting + ketonuria and/or weight loss >5% despite treatment

continued nausea and vomiting + coorbidity (i.e. unable to tolerate oral antibiotics required for a UTI)

Question 4

what is 2nd line treatment for hyperemesis gravidarum?

Answer 4

Metoclopramide

Ondansetron

Question 5

what are possible complications of hyperemesis gravidarum?

Answer 5

foetus small for dates, preterm birth 
central pontine myelinolysis 
wernickes encephalopathy 
mallory weiss tear 
acute tubular necrosis