Hyperemesis Gravidarum

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Hyperemesis Gravidarum

• excessive vomiting in pregnancy
• affects 1:1000 pregnancies
• continuous nausea and frequent vomits

Complications

• dehydration
• ketoacidosis

Treatment

• admit
• IV access
• plasma electrolytes
• 1l of 5% dextrose
• 1l of Hartmann's solution
• continue 3-4 L fluid / day
• Urine dipstick BD for
  • acetone
  • bile
  • sugar
  • specific gravity
• electrolytes daily
• metoclopramide 10mg IM
• ice to suck / NBM whilst IV running
• remain in hospital until 2 days after body weight increasing
• continue with antiemetics
  • pyridoxine 50mg QDS
  • metoclopramide 10mg BD/TDS
  • promethazine 25mg BD
    • but causes marked drowsiness

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