The Management of Nausea and Vomiting in Pregnancy and Hyperemesis Gravidarum

Flashcards based on key concepts from the guidelines on managing Nausea and Vomiting in Pregnancy and Hyperemesis Gravidarum.

What is Nausea and Vomiting of Pregnancy (NVP)?

NVP is defined as the symptom of nausea and/or vomiting during pregnancy when onset is prior to 16 weeks of gestation and where there are no other causes.

What are the key tools for classifying the severity of NVP and HG?

The Pregnancy-Unique Quantification of Emesis (PUQE) and HyperEmesis Level Prediction (HELP) tools are valid indices for classifying the severity.

How is Hyperemesis Gravidarum (HG) defined?

HG is diagnosed when symptoms start in early pregnancy, causing an inability to eat and drink normally and strongly limiting daily activities.

Why should ketonuria not be used to assess severity of HG?

Ketonuria is not an indicator of dehydration in pregnancy and should not be used to assess severity.

Which antiemetics are recommended as first-line treatment for NVP and HG?

First-line antiemetics include anti (H1) histamines, phenothiazines, and doxylamine/pyridoxine (Xonvea®).

What is the recommended approach for women who do not respond to single antiemetic treatment?

Combination of different drugs should be used in women who do not respond to a single antiemetic.

What is advised for all women admitted with vomiting or severely reduced dietary intake?

Thiamine supplementation should be given to prevent Wernicke's encephalopathy.

What are the risks of corticosteroids in treating HG?

Corticosteroids should be reserved for cases where standard therapies have failed and are associated with potential risks like elevated blood sugar levels.

What is the relationship between HG and psychological health?

Women with HG often report increased levels of depression, anxiety, and may have pre-existing mental health conditions exacerbated by HG.

What long-term effects may women experience after having HG?

Women who experience HG are at increased risk of postpartum depression, anxiety, and PTSD.