Nausea and vomiting of pregnancy Flashcards

1
Q

When does nausea and vomiting usually start in pregnancy?

A
  • in first trimester from 4-7 weeks, peaking around 8-12 weeks
  • usually resolve by 16-20 weeks
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2
Q

What is the severe form of nausea and vomiting in pregnancy called?

A

Hyperemesis gravidarum

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3
Q

What is thought to be responsible for nausea and vomiting during pregnancy?

A

-placenta producing hCG

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4
Q

Describe how nausea and vomiting can differ depending on the type of pregnancy

A
  • more severe in molar and multiple pregnancies due to higher hCG levels
  • also tends to be worse in first pregnancy and overweight women
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5
Q

How is hyperemesis gravidarum diagnosed?

A

criteria for diagnosing hyperemesis gravidarum are protracted NVP plus:

  • more than 5% weight loss compared with before pregnancy
  • dehydration
  • electrolyte imbalance
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6
Q

How can the severity of NVP be assessed?

A

using the Pregnancy-Unique Quantification of Emesis (PUQE) score, gives a score out of 15:

  • <7=mild
  • 7-12=moderate
  • > 12=severe
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7
Q

What antiemetics can be used to suppress nausea?

A
  • prochlorperazine
  • cyclizine
  • ondansetron
  • metoclopramide
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8
Q

How can mild cases of NVP be managed?

A

-with oral antiemetics at home

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9
Q

When should admission be considered for NVP?

A
  • unable to tolerate oral antiemetics and keep down any fluids
  • > 5% weight loss compared with pre pregnancy
  • urine dipstick shows ketones (+2 or more)
  • other medical conditions need treating
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10
Q

How can moderate-severe cases of NVP be managed?

A

may require ambulatory care or admission for:

  • IV/IM antiemtics
  • IV fluids (saline with KCI)
  • daily monitoring of U&Es while having IV therapy
  • Thiamine supplementation (prevents wernicke-korsakoff syndrome)
  • thromboprophylaxis (TED stocking and LMWH) during admission
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