№ 18Gynaecology14 min read
Vomiting in early pregnancy
1. Big picture
Vomiting in early pregnancy is usually normal nausea and vomiting of pregnancy, but the exam-important severe form is hyperemesis gravidarum.
The examiner wants you to recognize this clinical pathway:
Pregnant woman in 1st trimester + severe vomiting
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Assess dehydration and weight loss
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Check urine/blood ketones and electrolytes
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Exclude dangerous causes: molar pregnancy, multiple pregnancy, ectopic, infection, GI/surgical disease
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Rehydrate + correct electrolytes + give thiamine + pregnancy-safe antiemetics
The key danger is not the vomiting itself, but the consequences:
Persistent vomiting
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Dehy
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