Hyperemesis gravidarum

Hyperemesis gravidarum
Classification and external resources
Specialty	Gynecology
ICD-10	O21.1
ICD-9-CM	643.1
MedlinePlus	001499
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Hyperemesis gravidarum (HG) is a complication of pregnancy that is characterized by severe nausea and vomiting such that weight loss and dehydration occur. Signs and symptoms may include vomiting several times a day and feeling faint. It is more severe than morning sickness. Often symptoms get better after the 20th week of pregnancy but may last the entire pregnancy.

The exact cause of hyperemesis gravidarum is not known. Risk factors include the first pregnancy, multiple pregnancy, obesity, prior or family history of hyperemesis gravidarum, trophoblastic disorder, and a history of an eating disorder. The diagnosis is usually made based on the signs and symptoms. It has been technically defined as more than three episodes of vomiting per day such that weight loss of 5% or three kilograms has occurred and ketones are present in the urine. Other potential causes of the symptoms should be excluded including urinary tract infection and high thyroid levels.

Treatment includes drinking fluids and a bland diet. Recommendations may include electrolyte-replacement drinks, thiamine, and a higher protein diet. Some women require intravenous fluids. With respect to medications pyridoxine or are preferred.Prochlorperazine, dimenhydrinate, or ondansetron may be used if these are not effective. Hospitalization may be required. Psychotherapy may improve outcomes. Evidence for acupressure is poor.

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