HYPEREMESIS GRAVIDARUM



Hyperemesis gravidarum is the condition characterized by the severe nausea and persistent vomiting during pregnancy.

Nausea and vomiting are both common in pregnancy. Sometimes it can progress to hyperemesis.



Characteristics



The characteristics of hyperemesis are –

• Prolonged and severe nausea and vomiting

• Dehydration

• Ketosis

• Loss of body weight




Investigation Results



Investigations may show –

• Hypernatraemia

• Hypokalaemia

• Low serum urea

• Metabolic hypochloraemia

• Alkalosis

• Ketonuria

• Raised Haematocrit

• Increased specific gravity of the urine




Association



Hyperemesis may be associated with –

• Liver function test abnormalities

• Abnormal Thyroid function tests with biochemical thyrotoxicosis

(that is – raised free thyroxin levels and or suppressed thyroid stimulating hormone levels).




Pathophysiology



The incidence is 1:1000.

The pathophysiology is poorly understood.

The risk is increased in –

- Youth

- Non-smokers

- First time pregnant women (primipara)

- Those working outside the home

- Multiple pregnancy

- Molar pregnancy




A possible direct relationship between severity of hyperemesis, degree of biochemical hyperthyroidism, and the level of human chorionic gonadotropin (hcG) has been postulated.

Transient hyperthyroidism of hyperemesis gravidarum is a self-limiting hyperthyroidism.

It resolves by 18 weeks of pregnancy without sequelae and no treatment is required.



Management



Hyperemesis gravidarum may be a result of underlying disease.

The management of hyperemesis includes -

Differential diagnosis,

Routine Investigations and

Treatment.



Read more about the Management of Hyperemesis Gravidarum here...




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