Nausea and vomiting in pregnancy Flashcards
potential causes of NV in pregnancy
1 elevated levels of hCG hormone
2 decreased gastric emptying and decreased esophogeal spincter tone
3 hpylori infection
symptoms and when then occur
nausea vomiting retching vomitus - nonbilious and no blood any time of the day
course of NV
symptoms begin 4-6 weeks (8-10 rare)
worse at 7-12 weeks
lessen in 12-20 weeks
symptoms of hyperemesis gravidarum
severe unretractable vomiting dehydration ketosis electrolyte imbalance weight loss
adverse effects to fetus from hyperemesis gravidarum
none
lower rate of miscarriage?
as long as mother gains weight back no problem
risk factors for hyperemesis gravidarum
multiple pregnancy NVP in previous pregnancy history of GI problems family history molar pregnancy history of migraines
goals of therapy
prevent dehydration
control symptoms
maintain adequate nutrition
dietary and lifestyle modifications
eat small frequent meals separate solid and liquids by 30 min eat high protein snacks eat dry bland salty carbohydrate food avoid spicy fried or high fat maintain adequate food intake avoid strong smells
non pharms not totally proven
ginger
acupunture
hyponosis
thiamine use in NVP
only for very severe to prevent deficiencies
drug of choice for NVP
doxylamine and pyridoxine - diclectin
a first gen antihistamine and vit b6
side effects of diclectin
sedation
anticholinergic
when can diphenhydramine and dimenhydrinate be used
breakthough NV when in diclectin
what is metoclopramide and why is it reserved for severe
dopamine agonist
extrapyramidal side effect
combo that can be used for HG
metoclopramide and diphenhydramine
