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Hyperemesis Gravidarum

Lorena Likaj, MPH, MD and Robert A. Monteleone, M.D. Reviewed 06/2022
 


BASICS

  • Nausea and vomiting in pregnancy is a common condition that affects approximately 70 to 80% of pregnancies.

  • A more severe form of nausea and vomiting, hyperemesis gravidarum, affects 0.5 to 2% o...

DIAGNOSIS

The definition of hyperemesis gravidarum varies but often includes intractable nausea and vomiting in pregnancy, signs of dehydration, electrolyte imbalances after the exclusion of other cau...

TREATMENT

Pyridoxine and doxylamine (pregnancy Category A) are first-line treatments for hyperemesis gravidarum (1)[C]. This is followed by metoclopramide or ondansetron (pregnancy Category B) and th...

ONGOING CARE

Approximately 10 percent of patients with hyperemesis gravidarum will be affected throughout the pregnancy. 

FOLLOW-UP RECOMMENDATIONS

Overall quality of life and future fertility plans can...

REFERENCES

1
Maltepe  C, Koren  G. The management of nausea and vomiting of pregnancy and hyperemesis gravidarum—a 2013 update. J Popul Ther Clin Pharmacol.  2013; 20(2): e...

ADDITIONAL READING

  • Abas  MN, Tan  PC, Azmi  N, et al. Ondansetron compared with metoclopramide for hyperemesis gravidarum: a randomized controlled trial. Obstet Gynecol. ...

CODES

ICD10

  • O21.9 Vomiting of pregnancy, unspecified

  • O21.0 Mild hyperemesis gravidarum

  • O21.1 Hyperemesis gravidarum with metabolic disturbance

  • O21.2 Late vomiting of pregnancy

  • O21.8 Other vomiting complica...

CLINICAL PEARLS

  • Do not allow patients to become volume depleted. Once this occurs, it is more difficult to interrupt the process.

  • Do not be hesitant to use medications to assist the patient, as this ma...

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