🤰 Nausea/Vomiting in Pregnancy Overview

• 🕒 Typically diagnosed in the first trimester after other causes are excluded.
  

• ⏳ Symptoms usually start between 4-7 weeks, peak around 9-16 weeks, and generally resolve by 16-20 weeks.

• 🚩 Symptoms beginning after 11 weeks may indicate causes not related to pregnancy.

🔎 Hyperemesis Gravidarum

• 📉 Represents severe symptoms: prolonged nausea/vomiting, significant weight loss (>5% of pre-pregnancy weight), dehydration, and electrolyte imbalances.

• 🚨 It is a diagnosis of exclusion, ruling out other causes first.

🌡️ Risk Factors

• 🔬 Increased placental mass (e.g., molar gestation, multiple pregnancy), first pregnancy, personal or family history of severe nausea/vomiting or hyperemesis gravidarum, obesity.

👩‍⚕️ Assessment

• 🗣️ Discuss onset, duration, severity, and impact on daily life; assess risk factors and co-morbidities.

• 📝 Consider a validated questionnaire for assessing symptom severity.

• 🏥 Examine for dehydration, weight loss, and other causes or complications.

• 🔍 May need further tests for severe symptoms or suspected underlying causes.

🩺 Management

• 📚 Provide information and support resources.

• 🤗 Reassure that mild-to-moderate symptoms are common and manageable.

• 🍽️ Recommend dietary and lifestyle changes, ginger, and acupressure.

• 💊 Discuss avoiding certain medications and advise on available drug treatments (from first to third-line), based on severity and patient preference.

🏥 When to Consider Hospital Admission

• 🚨 If symptoms are moderate-to-severe with complications or suspected complications.

• 📊 If a risk score is above threshold.

• 💧 If symptoms persist despite primary care, or if there's clinical dehydration, significant weight loss, or inability to tolerate oral medications or fluids.

• 🧠 Address mental health concerns promptly.

References:

https://cks.nice.org.uk/topics/nausea-vomiting-in-pregnancy/