Hyperemesis Gravidarum
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Basics
Description
- Hyperemesis gravidarum is persistent vomiting in a pregnant woman that interferes with fluid and electrolyte balance as well as nutrition:
- Usually associated with the first 8 to 20 weeks of pregnancy
- Believed to have biomedical and behavioral aspects
- Associated with high estrogen and human chorionic gonadotropin (hCG) levels
- Symptoms usually begin ~2 weeks after first missed period.
- System(s) affected: endocrine/metabolic; gastrointestinal; reproductive
- Synonym(s): morning sickness
Pregnancy Considerations
Common condition during pregnancy, typically in the 1st and 2nd trimesters but may persist into the 3rd trimester
Epidemiology
Incidence
Hyperemesis gravidarum occurs in 1–2% of pregnancies.
Prevalence
Hyperemesis gravidarum is the most common cause of hospitalization in the first half of pregnancy and the second most common cause of hospitalization of pregnant women.
Etiology and Pathophysiology
- Unknown
- Possible psychological factors
- Hyperthyroidism
- Hyperparathyroidism
- Gestational hormones
- Liver dysfunction
- Autonomic nervous system dysfunction
- CNS neoplasm
- Addison disease
Risk Factors
- Obesity
- Nulliparity
- Multiple gestations
- Gestational trophoblastic disease
- Gonadotropin production stimulated
- Altered GI function
- Hyperthyroidism
- Hyperparathyroidism
- Liver dysfunction
- Female fetus
- Helicobacter pylori infection
General Prevention
Anticipatory guidance in 1st and 2nd trimesters regarding dietary habits in hopes of avoiding dehydration and nutritional depletion
- 2% of pregnancies have electrolyte disturbances.
- 50% of pregnancies have at least some GI disturbance.
Commonly Associated Conditions
Hyperthyroidism
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