Hyperemesis Gravidarum

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Questions and Answers

What is a significant indicator that vomiting is severe enough to cause dehydration?

Vomiting lasting longer than usual morning sickness

Inability to keep fluids or food down for more than 12 hours (correct)

Feeling lightheaded after eating

Vomiting occurring only in the morning

Which of the following symptoms is primarily a sign of dehydration?

Increased heart rate

Prolonged vomiting

Dry mucous membranes (correct)

Severe fatigue

What causes acetonuria during pregnancy?

Increased carbohydrate intake

Use of fats for energy due to starvation (correct)

Low levels of progesterone

Excessive hydration

Which hormonal changes are primarily responsible for severe vomiting during early pregnancy?

Rapidly increasing levels of hCG, progesterone, and estrogen Signup and view all the answers

What is typically monitored through daily weight evaluation during severe vomiting episodes?

Severity of dehydration and malnutrition Signup and view all the answers

What is the most appropriate initial management for a pregnant individual with prolonged vomiting?

IV hydration with glucose and thiamine Signup and view all the answers

Which symptom indicates tachycardia in the context of severe vomiting?

Rapid heartbeat due to dehydration Signup and view all the answers

What does ketosis indicate in a pregnant individual experiencing severe vomiting?

Insufficient carbohydrate intake leading to fat metabolism Signup and view all the answers

What is the primary reason for administering thiamine before dextrose in individuals with prolonged vomiting?

To prevent Wernicke’s encephalopathy Signup and view all the answers

Which medication is considered a first-choice treatment for nausea and vomiting during pregnancy?

Vitamin B6 Signup and view all the answers

What is one of the main risks to fetal growth if hyperemesis gravidarum is not properly managed?

Intrauterine growth restriction Signup and view all the answers

Which of the following approaches is recommended for restoring nutrition in individuals recovering from nausea?

Gradually reintroducing food Signup and view all the answers

What is a common treatment method if oral medications for nausea do not work?

Benzamides via IV Signup and view all the answers

Which symptom typically indicates a severe case of hyperemesis gravidarum?

Weight loss of more than 5% of body weight Signup and view all the answers

What potential complication can arise from severe dehydration due to vomiting?

Kidney injury Signup and view all the answers

Why is acupuncture considered a variable treatment option for nausea?

Its effectiveness is not consistently supported by research Signup and view all the answers

Which electrolyte imbalance is commonly caused by excessive vomiting?

Low sodium levels Signup and view all the answers

Which factor may increase the likelihood of recurrence of hyperemesis gravidarum in future pregnancies?

Experiencing hyperemesis gravidarum in a previous pregnancy Signup and view all the answers

Study Notes

Diagnosis

Prolonged vomiting exceeding typical morning sickness indicates the body struggles with hormonal changes in pregnancy.
Significant weight loss occurs due to inability to retain food or fluids, risking dehydration and malnutrition.
Acetonuria reflects large acetone excretion in urine, indicating fat is being burned as the primary energy source.
Ketosis results from the body's utilization of fat instead of carbohydrates, causing ketone accumulation in blood and urine.
Rapidly increasing levels of hCG, progesterone, and estrogen in early pregnancy can cause severe nausea and vomiting.

Signs and Symptoms

Lightheadedness and dizziness stem from dehydration, disrupting fluid and electrolyte balance.
Tachycardia results as the heart compensates for low blood volume from fluid loss.
Inability to keep fluids or food down for over 12 hours signals severe dehydration risk.
Dry mucous membranes indicate a lack of sufficient body fluids.
Poor skin turgor shows diminished skin elasticity due to dehydration.
Malaise reflects discomfort and fatigue associated with dehydration and prolonged vomiting.
Low blood pressure occurs from decreased blood volume due to severe fluid loss.

Lab Evaluation

Urinalysis revealing acetonuria indicates fat breakdown for energy due to starvation or malnutrition.
Ketones in urine illustrate reliance on fat as the main energy source, due to inadequate carbohydrate intake.
Daily weight monitoring provides insight into the severity of dehydration and malnutrition, allowing timely interventions.

Management in Pregnancy

IV hydration with dextrose and thiamine is vital to restore fluids and electrolytes; thiamine must precede dextrose intake to prevent Wernicke’s encephalopathy.
Kidney and liver function must be monitored regularly due to the risk of organ impairment from dehydration and malnutrition.
First-choice medications for nausea include Vitamin B6 and Doxylamine; both can be combined to enhance effectiveness.
Antihistamine H1 blockers can help inhibit the vomiting center in the brain.
If oral medications fail, second-choice IV medications like phenothiazines and benzamides can be utilized.
Acupuncture may reduce nausea but its effectiveness is variable and should be evaluated on an individual basis.
Gradually reintroducing food, consuming smaller frequent meals, avoiding triggers, and timing prenatal vitamins can help lessen nausea and improve nutrition.

Implications for Timing and Type of Birth

Symptoms typically peak around 9 weeks, subsiding around 20 weeks, but can persist throughout pregnancy for some.
Recurrence of hyperemesis gravidarum is common in subsequent pregnancies, affecting nutritional health and overall wellbeing.

Risks to the Fetus

Generally minimal risks exist if managed properly; however, severe malnutrition or dehydration can hinder fetal growth and lead to complications like intrauterine growth restriction.

Risks to the Pregnant/Birthing Person

Hospitalization may be necessary for severe cases requiring IV hydration and nutritional support.
Severe dehydration can cause complications including kidney injury or circulatory collapse.
Prolonged malnutrition may lead to muscle wasting as the body utilizes muscle tissue for energy.
Electrolyte imbalances from vomiting can result in dangerous conditions like cardiac arrhythmias.
Ketonuria signifies reliance on fat for energy due to inadequate intake, indicating starvation risk.
Weight loss over 5% signifies severity of hyperemesis gravidarum, complicating recovery.

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Description

Test your knowledge on the signs and symptoms of pregnancy complications such as severe nausea and dehydration. This quiz covers key indicators like acetonuria, ketosis, and hormonal impacts during early pregnancy. Assess your understanding of how these factors affect both the mother and the fetus.