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Nausea and vomiting in pregnancy

Evidence last reviewed: 13 Apr 2026
Topic last updated: 01 Apr 2025

Summary

Определение

Анамнез и осмотр

Ключевые диагностические факторы

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

Другие диагностические факторы

  • absence of thyroid enlargement/nodules
  • dry mucous membranes
  • postural dizziness
  • tachycardia
  • hypotension
  • ketotic breath
Полная информация

Факторы риска

  • 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
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • clinical diagnosis
Полная информация

Исследования, проведение которых нужно рассмотреть

  • CBC
  • basic metabolic panel
  • serum LFTs
  • serum BUN 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
Полная информация

Алгоритм лечения

Острый

without volume depletion

without volume depletion but failed conservative management

with volume depletion

Составители

Авторы

Jeffrey D. Quinlan, MD, FAAFP

Professor and Chair

Family Medicine

Carver College of Medicine

University of Iowa

Iowa City

IA

Раскрытие информации

JDQ declares that he has no competing interests.

Рецензенты

Sarah Jorgensen, DO

Faculty Physician

Family Medicine Residency

Naval Hospital Jacksonville

FL

Раскрытие информации

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

Раскрытие информации

YTJ declares that he has no competing interests.

D. Ashley Hill, MD

Associate Director

Department of Obstetrics and Gynecology

Florida Hospital

Orlando

FL

Раскрытие информации

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.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

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

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

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

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].Полный текст

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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