Vomiting during Pregnancy

Vomiting during Pregnancy (Hyperemesis Gravidarum): Symptoms, Complaints, Signs

The following symptoms and complaints may indicate hyperemesis gravidarum (vomiting of pregnancy): Pathognomonic (indicative of a medical condition) Excessive/whole-day vomiting (frequency of more than five times per day). This can lead to the subsequent symptomatology mentioned below: Difficulty in the intake of food and fluids Weight loss (weight loss of more than 5% of body … Vomiting during Pregnancy (Hyperemesis Gravidarum): Symptoms, Complaints, Signs

Vomiting during Pregnancy (Hyperemesis Gravidarum): Causes

Pathogenesis (development of disease) Hyperemesis gravidarum causes excessive vomiting. The cause is still unclear. It is thought to be related to the hormone HCG (human chorionic gonadotropin; pregnancy hormone). However, many women with elevated HCG do not have nausea (sickness) and vomiting. In addition, patients with chorionic carcinoma, who also have elevated HCG levels, do … Vomiting during Pregnancy (Hyperemesis Gravidarum): Causes

Vomiting during Pregnancy (Hyperemesis Gravidarum): Therapy

General measures Nicotine restriction (abstaining from tobacco use) – Smoking and passive smoking are best discontinued before pregnancy. Alcohol restriction (renunciation of alcohol) – for pregnant women is a strict ban on alcohol! Limited caffeine consumption (max. 240 mg caffeine per day; this corresponds to 2 to 3 cups of coffee or 4 to 6 … Vomiting during Pregnancy (Hyperemesis Gravidarum): Therapy

Vomiting during Pregnancy (Hyperemesis Gravidarum): Medical History

Medical history (history of illness) represents an important component in the diagnosis of hyperemesis gravidarum (vomiting of pregnancy). Family history Social history Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic and psychological complaints). How often do you experience vomiting? How long has the vomiting … Vomiting during Pregnancy (Hyperemesis Gravidarum): Medical History

Vomiting during Pregnancy (Hyperemesis Gravidarum): Or something else? Differential Diagnosis

Endocrine, nutritional, and metabolic diseases (E00-E90). Diabetic ketoacidosis – form of metabolic acidosis that is particularly common as a complication of diabetes mellitus in the presence of absolute insulin deficiency; causative is an excessive concentration of ketone bodies in the blood. Hyperthyroidism (hyperthyroidism). Addison’s disease (adrenocortical insufficiency) – disease in which there is primarily a … Vomiting during Pregnancy (Hyperemesis Gravidarum): Or something else? Differential Diagnosis

Vomiting during Pregnancy (Hyperemesis Gravidarum): Test and Diagnosis

Laboratory parameters of the 1st order – obligatory laboratory tests. Small blood count (hematocrit). Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood), sediment, if necessary urine culture (pathogen detection and resistogram, that is, testing of suitable antibiotics for sensitivity/resistance) [ketone bodies (+), specific gravity, aciduria]. Electrolytes – chloride, sodium, … Vomiting during Pregnancy (Hyperemesis Gravidarum): Test and Diagnosis

Vomiting during Pregnancy (Hyperemesis Gravidarum): Drug Therapy

Therapeutic target Improvement of symptomatology Therapy recommendations The following are therapy recommendations according to severity. Severity 1 Nutritional counseling ev. dietary changes: Low-fat High in carbohydrates Frequent small meals Morning meal lying in bed Avoid: Acidic foods Unpleasant odors Psychosomatic care, if necessary Drug therapy with antiemetics Severity 2 Early inpatient admission Elimination of possible … Vomiting during Pregnancy (Hyperemesis Gravidarum): Drug Therapy

Vomiting during Pregnancy (Hyperemesis Gravidarum): Diagnostic Tests

Obligatory medical device diagnostics. Abdominal sonography (ultrasound examination in pregnancy) – primarily to verify an intact pregnancy (exclusion of multiple pregnancy, trophoblastic disease, and neoplasia, if applicable) Optional medical device diagnostics – depending on the results of the history, physical examination and mandatory laboratory parameters – for differential diagnostic clarification. Magnetic resonance imaging of the … Vomiting during Pregnancy (Hyperemesis Gravidarum): Diagnostic Tests

Vomiting during Pregnancy (Hyperemesis Gravidarum): Prevention

To prevent hyperemesis gravidarum (pregnancy vomiting), attention must be paid to reducing individual risk factors. Behavioral risk factors Psychosocial situation Stress, severe stress situations Overweight (BMI ≥ 25, obesity). General preventive measures Correspond to those of emesis (vomiting): Nutrition: Low fat High carbohydrate Frequent small meals Morning meal lying in bed Avoid: Acidic foods Unpleasant … Vomiting during Pregnancy (Hyperemesis Gravidarum): Prevention