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Overview :
Nausea and vomiting is common during early pregnancy
("morning sickness") but is usually mild. Rarely a woman may
experience severe, persistent nausea and vomiting sufficient to cause
significant metabolic derangements requiring hospitalization.
Features of hyperemesis gravidarum:
(1) severe and
persistent nausea and vomiting
(2) weight loss
(greater than 5% of prepregnancy weight)
(3) moderate to
severe dehydration
(4) electrolyte
and acid base disturbances (hypochloremia, hyponatremia, metabolic acidosis)
(5) ketonuria
Differential diagnosis:
(1) normal levels of emesis
(2) bowel obstruction
(3) acute viral infections with gastrointestinal manifestations
(4) diabetic ketoacidosis
(5) urinary tract infection
Complications:
(1) malnutrition
(2) vitamin deficiencies, especially thiamine
(3) refeeding syndrome during nutritional repletion
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