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%
其他诊断因素
- absence of thyroid enlargement/nodules
- dry mucous membranes
- postural dizziness
- tachycardia
- hypotension
- ketotic breath
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
诊断性检查
首要检查
- clinical diagnosis
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
治疗流程
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
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.
Differentials
- Viral gastroenteritis
- Food poisoning
- Cholecystitis
Mais Diagnósticos diferenciaisGuidelines
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