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Hyperemesis gravidarum

Extracted from Survival Guide to Midwifery, 2nd Edition (2012) Diane M. Fraser and Margaret A. Cooper, Oxford; Churchill Livingstone: 2012. Courtesy Elsevier

Excessive nausea and vomiting that starts between 4 and 10 weeks' gestation, resolve before 20 weeks, and requires intervention is known as hyperemesis gravidarum. The woman presents with inability to retain food or fluids, leading to dehydration and malnourishment. She may have lost weight and be distressed and debilitated by her symptoms. Admission is required for assessment and management of symptoms.

  • Hypovolaemia and electrolyte imbalance are corrected by intravenous infusion
  • Vitamin supplements can be given parenterally, particularly where hyperemesis has been prolonged
  • Initially nothing is given by mouth; fluids and diet are gradually reintroduced as the condition improves
  • Antiemetics may be prescribed

The Practising Midwife featured article

Pregnancy nausea and vomiting - the role of the midwife

2012; 15(9): 17 - 19

Author: Roger Gadsby

Further reading

National Institute for Health and Care Excellence. Clinical Knowledge Summaries (2013). Nausea/vomiting in pregnancy. Available at: http://cks.nice.org.uk/nauseavomiting-in-pregnancy

American Society of Obstetrics & Gynecology (2015) Practice Bulletin Summary 153: Nausea and vomiting of pregnancy. Obstetrics & Gynecology 2015, 126 (3), 687-688. Available at: http://journals.lww.com/greenjournal/Abstract/2015/09000/Practice_Bulletin_Summary_No__153___Nausea_and.42.aspx

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