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Y4R2 - Obstetrics I 🤰 > L12: Hyperemesis Gravidarum > Flashcards

L12: Hyperemesis Gravidarum Flashcards

1
Q

Def of Emesis gravidarum

A
  • Vomiting that occurs mostly during early morning, usually appears at 6 weeks & disappears after 14 weeks & doesn’t affect the general condition of woman.
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2
Q

Def of Hyperemesis graviderum

A
  • Severe vomiting during first 14 weeks affecting the general condition of woman

OR

  • persistent vomiting after 14 weeks & before 20 weeks.
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3
Q

Incidence of Hyperemesis graviderum

A

1/500

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4
Q

Compare between Morning Sickness & Hyperemesis Gravidarum

A
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5
Q

Causes of Hyperemesis graviderum

A
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6
Q

Theories of Hyperemesis graviderum

  • HCG Theory
A
  • High HCG level stimulates CRTZ (this may explain high incidence in vesicular mole & multifetal pregnancy).
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7
Q

Theories of Hyperemesis graviderum

  • Psychological & Emotional Theory
A
  • May play role through stimulation of CRTZ (this may be evidenced by improvement of condition after hospitalization & isolation from stressful home environment).
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8
Q

Theories of Hyperemesis graviderum

  • Allergic Theory
A
  • Allergic reaction to pregnancy hormones (HCG, estrogen & progesterone
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9
Q

Theories of Hyperemesis graviderum

  • Infection Theory
A

Infection è Helicobacter Pylori bacteria (gastritis) may play role.

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10
Q

Theories of Hyperemesis graviderum

  • Nutritional Theory
A

Vitamins B1 & B6 deficiency.

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11
Q

Theories of Hyperemesis graviderum

  • Thyroid Gland Activation Theory
A

May Play Role

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12
Q

Pathology of Hyperemesis graviderum

A
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13
Q

Hyperemesis graviderum

  • Biochemical Disorders
A
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14
Q

Hyperemesis graviderum

  • Biochemical Disorders (Electrolyte Changes)
A

↓↓ Na+ & Clˉ & ↑↑ blood urea.

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15
Q

Hyperemesis graviderum

  • Biochemical Disorders (Metabolic Changes)
A

Hypoglycemia & ketoacidosis (ketone bodies).

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16
Q

Hyperemesis graviderum

  • Biochemical Disorders (Circulatory Changes)
A

Hypovolemia & hemoconcentration

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17
Q

Hyperemesis graviderum

  • Biochemical Disorders (Urinary Changes)
A

Oliguria, Ketonuria, proteinuria & ↑↑ urinary urea

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18
Q

Hyperemesis graviderum

  • Organic Disorders
A
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19
Q

Hyperemesis graviderum

  • Organic Disorders (Liver)
A

fatty degeneration

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20
Q

Hyperemesis graviderum

  • Organic Disorders (Kidney)
A

Tubular & Gomerular degeneration

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21
Q

Hyperemesis graviderum

  • Organic Disorders (Heart)
A

Subendocardial He, degeneration, brown atrophy of the heart

22
Q

Hyperemesis graviderum

  • Organic Disorders (CNS)
A

Peripheral neuritis, Wernicke’s encephalopathy & Korsakoff’s syndrome

23
Q

Hyperemesis graviderum

  • Organic Disorders (Eye)
A

Optic neuritis, retinal hge without exudates, visual field defects

24
Q

Dx of Hyperemesis Gravidarum

A

…

25
Q

Dx of Hyperemesis Gravidarum

  • Clinically
A
26
Q

DHD Symptoms in Hyperemesis Gravidarum

A
  • Hypotension.
  • Decreased temperature.
  • Oliguria.
  • Dry tongue.
  • Sunken eyes.
  • Dry wrinkled skin.
27
Q

Starvation Symptoms in Hyperemesis Gravidarum

A
  • Emaciation.
  • Loss of weight.
28
Q

General Manifestations in Hyperemesis Gravidarum

A
  • Vital signs: Tachycardia, hypotension & subnormal temperature.
  • Jaundice: In severe cases
  • Oliguria: In late cases.
29
Q

Nervous Manifestations in Hyperemesis Gravidarum

A
  • Peripheral neuritis: Pain & tingling sensation.
  • Wernicke’s encephalopathy: Nystagmus, optic neuritis & diplopia
  • Korsakoff’s syndrome: Confusion & memory loss for recent events.
30
Q

Manifestations of severe Hyperemesis Gravidarum

A
31
Q

Investigations for Hyperemesis Gravidarum

  • Blood
A
32
Q

Investigations for Hyperemesis Gravidarum

A
33
Q

Investigations for Hyperemesis Gravidarum

  • Urine
A
34
Q

Investigations for Hyperemesis Gravidarum

  • US
A
35
Q

Investigations for Hyperemesis Gravidarum

  • Fundoscope
A
36
Q

DDx of Hyperemesis Gravidarum

A
37
Q

DDx of Hyperemesis Gravidarum

  • Obstetric Causes
A
38
Q

DDx of Hyperemesis Gravidarum

  • Gynecological Causes
A
39
Q

DDx of Hyperemesis Gravidarum

  • Other Causes
A
40
Q

TTT of Mild Cases of Hyperemesis Gravidarum

A
41
Q

TTT of Mild Cases of Hyperemesis Gravidarum

  • Fluids
A

Ample amounts must be taken to avoid dehydration.

42
Q

TTT of Mild Cases of Hyperemesis Gravidarum

  • Isolation
A

Form stressful home environment (hospitalization may be needed).

43
Q

TTT of Mild Cases of Hyperemesis Gravidarum

  • Diet
A

Small, frequent, semisolid, rich in CHO & poor in fat & proteins.

44
Q

TTT of Mild Cases of Hyperemesis Gravidarum

  • Drugs
A
45
Q

TTT of Severe Cases of Hyperemesis Gravidarum

A
46
Q

TTT of Severe Cases of Hyperemesis Gravidarum

  • Isolation
A

single room & no visitors are allowed

47
Q

TTT of Severe Cases of Hyperemesis Gravidarum

  • NPO
A

For 48 Hours

48
Q

TTT of Severe Cases of Hyperemesis Gravidarum

  • IV Fluids
A

Glucose 5% & normal saline 0.9

49
Q

TTT of Severe Cases of Hyperemesis Gravidarum

  • Drugs
A

As above + sedatives

50
Q

TTT of Severe Cases of Hyperemesis Gravidarum

  • Observation
A
51
Q

In Hyperemesis Gravidarum, Termination of pregnancy is indicated in ……

A
52
Q

In Hyperemesis Gravidarum, Indication of hospitalization …….

A

Y4R2 - Obstetrics I 🤰 (10 decks)

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