hyperemesis gravidarum

Question 1

when is hyperemesis gravidarum most common?

Answer 1

8-12 weeks but may persist up to 20 weeks

Question 2

what is hyperemesis gravidarum associated with?

Answer 2

• multiple pregnancies
• trophoblastic disease
• hyperthyroidism
• nulliparity
• obesity

Question 3

what tried must be present for dx fo hyperemesis gravidarum?

Answer 3

• 5% pre-pregnancy wt loss
• dehydration
• electrolyte imbalance

Question 4

what can be used to classify the severity of NVP (nausea and vomiting of pregnancy)?

Answer 4

Pregnancy-Unique Quantification of Emesis (PUQE) score

Question 5

how is hyperemesis gravidarum managed?

Answer 5

• 1st line: antihistamines e.g. promethazine
• 2nd line: ondansetron, metoclopramide
• admission may be needed for IV hydration
• if ? Wernicke’s (diplopia, ataxia): IV vitamin B and C complex (e.g. Pabrinex)

Question 6

what are the complications of hyperemesis gravidarum?

Answer 6

• Wernicke’s encephalopathy
• Mallory-Weiss tear
• central pontine myelinolysis
• acute tubular necrosis
• fetal: small for gestational age, pre-term birth