N&V, Hyperemesis gravidarum Flashcards
when do symptoms of N+V typically start in pregnancy?
when do they peak?
when do they resolve?
4-7
10-12
16-20
what is the underlying pathology of N+V in pregnancy?
it is driven by bHCG
2 types of pregnancy which cause worse N+V
molar pregnancy
multiple pregnancy
2 risk factors in the mother which can cause worse N+V
first pregnancy
overweight/obese
requirement for clinical diagnosis of N+V of pregnancy
it needs to start in the first trimester
also other diagnoses need to be excluded
criteria for diagnosis of hyperemesis gravidarum (1 + 1/3)
protracted N+V
> 5% weight loss
dehydration
electrolyte imbalance
PUQE for:
mild
moderate
severe
N+VoP
1-7
7-12
13+
4 options for anti-emetics in pregnancy (from 1st to 4th preference)
prochlorperazine
cyclizine
ondasetron
metoclopramide
2 medications for reflux in pregnancy
ranitidine
omeprazole
2 complimentary therapies for N+VoP
ginger
acupressure of the inner wrist (PC6)
3 reasons for admission of N+VoP
cannot tolerate fluids
ketones in the urine (2+)
> 5% weight loss
how often will U+Es be monitored for a patient admitted for N+V?
daily
suggest 4 medications that a patient admitted for N+VoP may be given
IV/IM anti-emetics
fluids (including potassium)
thiamine supplementation
thromboprophylaxis (pregnant + immobile?)
