Hyperemesis gravidarum

Hyperemesis gravidarum
Specialty	Obstetrics Gastroenterology
Symptoms	Nausea and vomiting such that weight loss and dehydration occur
Duration	Often gets better but may last entire pregnancy
Causes	Unknown
Risk factors	First pregnancy, multiple pregnancy, obesity, prior or family history of hyperemesis gravidarum, trophoblastic disorder
Diagnosis	Based on symptoms
Differential diagnosis	Urinary tract infection, high thyroid levels
Treatment	Drinking fluids, bland diet, intravenous fluids
Medication	Pyridoxine, metoclopramide
Frequency	~1% of pregnant women

File:Pregnant woman.jpg

Pregnant woman

Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting in pregnancy, far more extreme than the typical morning sickness many pregnant individuals experience. It usually occurs during the first trimester of pregnancy and may last until delivery.

Symptoms

HG is characterized by persistent and severe vomiting, leading to weight loss of more than 5% of pre-pregnancy body weight, dehydration, and electrolyte imbalances such as hyponatremia and hypokalemia.

Causes

The exact cause of HG remains unknown, although hormonal changes during pregnancy, especially the rise in levels of human chorionic gonadotropin (HCG), may play a part. Genetic factors and prior history of HG also seem to contribute to the risk.

Diagnosis

HG is typically diagnosed based on the patient's symptoms and physical examination. Tests may be done to rule out other potential causes of the symptoms and to assess the severity of dehydration and electrolyte imbalance.

Treatment

The first line of treatment for HG is usually conservative, focusing on dietary changes and rest. However, most patients require hospital admission for intravenous fluid and electrolyte replacement. Anti-emetic drugs can be used to control vomiting. In severe cases, enteral or parenteral nutrition may be required.

Prognosis

With appropriate management, the prognosis for hyperemesis gravidarum is generally good, although it may significantly affect the individual's quality of life during pregnancy. It can lead to complications such as Wernicke's encephalopathy if left untreated.

See Also

• Nausea
• Pregnancy
• Morning sickness

External links

• American Family Physician - Hyperemesis Gravidarum
• PubMed Central - Hyperemesis Gravidarum: Current Perspectives

Further Reading

• HER Foundation. Understanding Hyperemesis. HER Foundation, 2020.