- Severe nausea and vomiting.
- Food aversions.
- Weight loss of 5% or more of pre-pregnancy weight.
- Decrease in urination.
- Extreme fatigue.
- Low blood pressure.
- Rapid heart rate.
- Loss of skin elasticity.
- Secondary anxiety/depression.
- Urinalysis for ketones and specific gravity: A sign of starvation, ketones may be harmful to fetal development. High specific gravity occurs with volume depletion.
- Serum electrolytes and ketones: Assess electrolyte status to evaluate for low potassium or sodium, identify hyperchloremic metabolic alkalosis or acidosis, and evaluate renal function and volume status.
- Liver enzymes and bilirubin: Elevated transaminase levels may occur in as many as 50% of patients with hyperemesis gravidarum. Mild transaminitis often resolves once the nausea has resolved. Significantly elevated liver enzymes, however, may be a sign of another underlying liver condition, such as hepatitis (viral, ischemic, autoimmune), or some other etiology of liver injury.
- Amylase/lipase: Amylase level is elevated in approximately 10% of patients with hyperemesis gravidarum. Lipase, when combined with amylase, can increase the specificity in diagnosing pancreatitis as an etiology.
- TSH, free thyroxine: Hyperemesis gravidarum is often associated with a transient hyperthyroidism and suppressed TSH levels in 50-60% of cases. However, an elevated free thyroxine may suggest that overt hyperthyroidism is present, thus necessitating further workup and treatment.
- Urine culture: This may be indicated because urinary tract infection is common in pregnancy and can be associated with nausea and vomiting.
- Calcium level: Consider measuring Ca++ levels. Some rare cases have been reported of hypercalcemia being associated with hyperemesis gravidarum, resulting from hyperparathyroidism.
- Hematocrit: This may be elevated because of volume contraction.
- Hepatitis panel: If clinically indicated, hepatitis A, B, or C may be confused with hyperemesis gravidarum.
- Obstetric ultrasonography is usually warranted in patients with HEG to evaluate for multiple gestations or trophoblastic disease.
- Additional imaging studies generally are not needed unless the clinical presentation is atypical (eg, nausea and/or vomiting beginning after 9-10 wk of gestation, nausea and/or vomiting persisting after 20-22 wk, acute severe exacerbation) or another disorder is suggested based on history or physical examination findings.
- If indicated clinically, performing upper abdominal ultrasonography to evaluate the pancreas and/or biliary tree appears to be a low-risk study.
- In rare cases, abdominal CT scan or even MRI may be indicated if appendicitis is under consideration as a cause of nausea and vomiting in pregnancy.
- Nasogastric - restores nutrients through a tube passing through the nose and to the stomach.
- Percutaneous endoscopic gastrostomy - restores nutrients through a tube passing through the abdomen and to the stomach; requires a surgical procedure.
A large-scale review of clinical trials for the past 25 years confirms that walnuts are the great choice for people who want to support their cardiovascular health. The scientists reviewed 26 randomized studies with 1,059 participants in total whose age was from 22 to...
A new study, published in the medical journal JAMA, finds that the more teenagers involved in social media, the higher their risk is to develop the symptoms of attention deficit hyperactivity disorder (ADHD). These symptoms may include inattention, hyperactivity,...
We all know that doing sports is very important, both for health and for a beautiful body. But at the moment when we decide to finally take the path, we are faced with the question: what kind of sport is right for me? So, let's start with the fact that a lot of people...read more
Pranayama is not just a complex of breathing exercises. It is a complex process, during which a person receives vital energy - prana from the air. Literally pranayama is translated as "stopping breathing". Hence the main goal of the whole breathing gymnastics is to be...read more
Experts often advise people as suitable trainings to climb stairs, rather than use the elevator. And here are 6 reasons why we should do this regularly. Classes on the treadmill or with the ellipsoid simulator in daily mode seem too boring. They can be replaced by a...read more