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.