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Chapter 14 - Hyperemesis in pregnancy

from Section 3 - Specialized requirements

Published online by Cambridge University Press:  26 February 2010

Michael E. Symonds
Affiliation:
University of Nottingham
Margaret M. Ramsay
Affiliation:
University of Nottingham
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Summary

Onset of hyperemesis gravidarum (HG) usually occurs between the 4th and 10th weeks of gestation, with associated progressive weight loss, ketosis, and dehydration in association with abnormal serum electrolytes, including hyponatremia, hypochloremia, and hypokalemia. Appropriate fluid, electrolyte, and vitamin resuscitation is the initial treatment for HG. This regimen includes generous supplementation of thiamine, as well as vitamin B6 (pyridoxine), which, although usually given in conjunction with antihistamines, has been found to ameliorate nausea and vomiting of pregnancy by itself. It has been understood for some time that women suffering from HG are at high risk for malnutrition, whether monitored by percentage of body loss or by serum markers of nutriture. Infants born to hyperemetic mothers have a significantly lower gestational age as well as a significantly longer length of hospital stay than infants born to control mothers.
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Publisher: Cambridge University Press
Print publication year: 2010

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