Hyperemesis Gravidarum
Nausea and vomiting in pregnancy is common and at best an unpleasant experience for the patient, and at worst can be life threatening. It normal starts @ 4-7/40, peaks @ 9/40, and finishes @ 20/40.
We need to conduct a thorough history and examination looking for causes other than a high βHCG. these include:
- Abdominal pathology
- Urinary pathology
- Infections
- Drug History
- Chronic H.Pylori
- Women that are accepted to GAU from HRI may be considered for transfer using own transport if they can be driven to CRH and have NEWS2 of 3 or less after initial hydration and parenteral antiemetics
RCOG Patient Advice Sheet – Available HERE
GAU Follow-Up Email: gynae.EDreferrals@cht.nhs.uk
Recommended Antiemetics
Ginger has been shown to reduce nausea and vomiting, and may be a n alternative if patients with mild symptoms who don’t wish to take medication.
Ondansetron WARNING: MHRA (Medicines & Healthcare products Regulatory Agency) has recently published a warning regarding the use of ondasetron in early pregnancy.leading to a small but significant risk of cleft lip
RCOG – The Management of Nausea andVomiting of Pregnancy and Hyperemesis Gravidarum