Hyperemesis gravidarum

Hyperemesis gravidarum or simply pregnancy induced vomitting/nausea is a condition that usually happened during the 1st trimester of pregnancy (often around 8 - 12 weeks of gestation).

causes are unknown, leading explanation ranging from raised levels of beta HCG (human chorionic gonadotrophin) to increased level of estrogen leading to nausea and regurgitation of stomach acids in some women.

symptoms include loss of weight, dehydration, metabolites imbalance and nutritional deficiency and in severe cases might lead to acute renal failure and may cause baby to have SGA ( small for gestation age) or LBW (low birth weight)

diagnosis are often made base on clinical symptoms reflecting the degree of dehydration and followed by a urine test on ketone levels mirroring the degree of dehydration

treatment are divided to outpatient and inpatient and are justified by clinical symptoms, physical examination findings and laboratory investigation result.

for outpatient treatment its normally given anti emetics e.g. tablets maxalon 10 mg tds/prn and advices

for inpatient treatment its based on the severity of symptoms, degree of dehydration and with urine ketone level of 2+ and above will be warranted for admission. patient will usually be given 6 pints of fluids per 24 hour with intravenous anti emetics

criteria for discharge will be depending on urine ketone level and overall patient well being.