By ULY CLINIC

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Vomiting in Pregnancy and Hperemesis Gravidarum

 

Introduction

 

It is severe nausea and vomiting in early pregnancy requiring hospital admission and rehydration. 

 

Diagnostic Criteria 

 

• Weight loss

• Nausea and vomiting typically in early pregnancy 

• Dehydration

• Altered general status (fast pulse, restlessness) 

 

 Investigations 

 

• Full blood count

• Blood for urea, electrolytes and serum creatinine

• Urinalysis, micro urine and culture, ketonuria

• Liver function tests

• Thyroid function tests

• Obstetric ultrasound

 

Non-pharmacological Treatment

 

• Nil per oral (nothing by mouth) for 24–48 hrs.

• Input/output for 24–48 hrs.

• Monitor electrolytes for 24hrs 

• Counselling

• Reassurance

• Emotional support

• Rest

• Life style adjustment

• Ensure adequate hydration

• Frequent small carbohydrate meal

 

Pharmacological Treatment

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• Ringers Lactate with Normal Saline according to daily needs and severity. 

AND

• Vitamin B1 (Thiamine) 100mg per day mix in intravenous rehydration solution 

AND

• Metoclopramide: IM 5–10 mg 8 hourly till vomiting stops.

OR

• Promethazine (IM) 12.5 mg twice daily

 

Referral:

 

Depends on the status of the patient, refer to a hospital if vomiting is intractable and if there is a need for high volume replacement.

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Updated on, 3.11.2020

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References

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1. STG