Hyperemesis Gravidarum

Definition

Nausea and vomiting in pregnancy that significant enough to cause dehydration, metabolic alkalosis, ketonuria, weight loss (>5%), hypokalemia

Risk Factors

Multi gestation, Family history or personal hx in prior pregnancy

Labs

CBC, lytes, UA, TSH, LFT

Therapy

IV hydration with dextrose +/- thiamine

hospitalization for monitoring

Pharmacotherapy

Diglecis 

Ondansetron 4 to 8 mg q8hr

Promethazine 12.5 to 25 q4-6hr

Metoclopromide 5 to 10mg q8hr

Diet

Usually begin with a diet consisting of bananas, rice, applesauce and toast (BRAT diet) and then advance the diet as tolerated. 

UpToDate