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Nausea and vomiting in pregnancy

Last reviewed: 18 Aug 2025
Last updated: 01 Apr 2025

Summary

定义

病史和体格检查

关键诊断因素

  • presence of risk factors
  • first trimester of pregnancy
  • weight loss of >5%
完整详情

其他诊断因素

  • absence of thyroid enlargement/nodules
  • dry mucous membranes
  • postural dizziness
  • tachycardia
  • hypotension
  • ketotic breath
完整详情

危险因素

  • family history of hyperemesis gravidarum
  • previous history of NVP
  • multiple gestation or increased placental mass
  • gestational trophoblastic disease
  • other causes of increased placental mass
  • female fetus
  • history of motion sickness
  • history of migraine headache
完整详情

诊断性检查

首要检查

  • clinical diagnosis
完整详情

需考虑的检查

  • FBC
  • basic metabolic panel
  • serum LFTs
  • serum urea and creatinine
  • serum thyroid-stimulating hormone (TSH) and free thyroxine (T4)
  • urinalysis
  • urine or serum ketones
  • fetal ultrasound with nuchal translucency
  • serum analytes
  • Helicobacter pylori breath test
  • urine culture
  • serum amylase and lipase
  • abdominal ultrasound
  • renal ultrasound
  • cranial CT or MRI
完整详情

治疗流程

急症处理

without volume depletion

without volume depletion but failed conservative management

with volume depletion

撰稿人

作者

Jeffrey D. Quinlan, MD, FAAFP

Professor and Chair

Family Medicine

Carver College of Medicine

University of Iowa

Iowa City

IA

利益声明

JDQ declares that he has no competing interests.

同行评议者

Sarah Jorgensen, DO

Faculty Physician

Family Medicine Residency

Naval Hospital Jacksonville

FL

利益声明

SJ declares that she has no competing interests.

Yosra Tahir Jarjees, MD

Assistant Professor

Head of Department of Obstetrics and Gynecology

Mosul College of Medicine

Mosul

Iraq

Declarações

YTJ declares that he has no competing interests.

D. Ashley Hill, MD

Associate Director

Department of Obstetrics and Gynecology

Florida Hospital

Orlando

FL

Declarações

DAH declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Goodwin TM. Hyperemesis gravidarum. Clin Obstet Gynecol. 1998 Sep;41(3):597-605. Resumo

American College of Obstetricians and Gynecologists. Practice bulletin no. 189: nausea and vomiting of pregnancy. Jan 2018 [internet publication].Texto completo

Matthews A, Haas DM, O'Mathúna DP, et al. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev. 2015;(9):CD007575.Texto completo  Resumo

Royal College of Obstetricians and Gynaecologists. Green-top guideline no. 69: the management of nausea and vomiting in pregnancy and hyperemesis gravidarum. Feb 2024 [internet publication].Texto completo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
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