Toxicosis of Pregnancy

Question 1

What is Toxicosis of pregnancy?

Answer 1

State of health of pregnant woman due to poisoning by harmful substances due to development of fetus.

Most commonly nausea, vomiting

Question 2

Types of toxicosis of pregnancy?

Answer 2

<20 weeks - N&V Hyperemesis gravidarum
>20 weeks - Pre-eclampsia, Eclampsia

Question 3

Characteristics of vomiting in pregnancy? What causes it?

Answer 3

Usually morning sickness. but can be any time of day. Caused by hormonal changes (high HCG)

Question 4

What are the degrees of Nausea and Vomiting of Pregnancy(NVP)?

Answer 4

1. Light vomiting - 2-4x per day. esp after meals
2. Moderate vomiting - 5-10x per day. Weight loss, ketosis
3. Severe vomiting - hyperemesis gravidarum - 20-25x daily.

Question 5

What is hyperemesis gravidarum?

Answer 5

uncontrolled, severe vomiting requiring hospitalization

Question 6

Clinical symptoms of HG?

Answer 6

Vomiting - day and night ( peak at 9 weeks, dissapear at 20 weeks)
Ptyalism - Excessive salivation. Extremely dry mucosa+speech disturbances
Severe dehydration - Hypotension, taychcaria, tachypnea, dizzy, drowsy
Ketonuria
Weight loss (more than 5%)
Electrolyte imbalance

Question 7

Risk factors of HG?

Answer 7

increased HCG -

multiple gestation,
molar pregnancy (Gestational Trophoblastic Disease)
Nulliparity
Early pregnancy
Risk of HG -> decreases with advanced maternal age

Question 8

Diagnosis of HG? Investigations?

Answer 8

Onset is in first trimester
Diagnostic triad:
1. >5% weight loss
2. Dehydration
3. Electrolyte imbalance

Investigation - weight, dehydrations signs (stats), Urinalysis for ketones, serum electrolytes. US to show Multiple gestation and trophoblastic disease