Last reviewed: April 2018
Last updated: March  2018

Summary

Definition

History and exam

Key diagnostic factors

  • first trimester of pregnancy
  • weight loss of >5%

Other diagnostic factors

  • absence of thyroid enlargement/nodules
  • absence of central nervous system (CNS) signs
  • dry mucous membranes
  • postural dizziness
  • tachycardia
  • hypotension
  • ketotic breath

Risk factors

  • 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

Diagnostic investigations

1st investigations to order

  • complete blood count
  • basic metabolic panel
  • serum liver function tests
  • serum BUN and creatinine
  • serum thyroid-stimulating hormone (TSH) and free T4
  • urinalysis
  • urine or serum ketones
  • fetal ultrasound with nuchal translucency
  • serum analytes
  • Helicobacter pylori breath test
Full details

Investigations to consider

  • urine culture
  • serum amylase and lipase
  • RUQ ultrasound
  • renal ultrasound
  • cranial CT or MRI
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Associate Professor

Family Medicine

Uniformed Services University of Health Sciences

Bethesda

MD

Disclosures

JDQ declares that he has no competing interests.

Peer reviewers VIEW ALL

Faculty Physician

Family Medicine Residency

Naval Hospital Jacksonville

FL

Disclosures

SJ declares that she has no competing interests.

Assistant Professor

Head of Department of Obstetrics and Gynecology

Mosul College of Medicine

Mosul

Iraq

Disclosures

YTJ declares that he has no competing interests.

Associate Director

Department of Obstetrics and Gynecology

Florida Hospital

Orlando

FL

Disclosures

DAH declares that he has no competing interests.

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