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Náuseas e vômitos da gravidez

Última revisão: 11 Sep 2025
Última atualização: 01 Apr 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • presença de fatores de risco
  • primeiro trimestre da gestação
  • perda de peso de >5%
Detalhes completos

Outros fatores diagnósticos

  • ausência de nódulos/aumento da tireoide
  • membranas mucosas ressecadas
  • tontura postural
  • taquicardia
  • hipotensão
  • respiração cetótica
Detalhes completos

Fatores de risco

  • história familiar de hiperêmese gravídica
  • história pregressa de náusea e vômitos da gravidez
  • gestação múltipla ou massa placentária aumentada
  • doença trofoblástica gestacional
  • outras causas de massa placentária aumentada
  • feto do sexo feminino
  • História familiar de cinetose
  • história de enxaqueca
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • diagnóstico clínico
Detalhes completos

Investigações a serem consideradas

  • Hemograma completo
  • perfil metabólico básico
  • testes séricos da função hepática
  • ureia e creatinina séricas
  • hormônio estimulante da tireoide (TSH) sérico e tiroxina livre (T4)
  • urinálise
  • corpos cetônicos no soro ou na urina
  • ultrassonografia fetal com medida da translucência nucal
  • exames bioquímicos gerais
  • teste respiratório para Helicobacter pylori
  • urocultura
  • amilase e lipase séricas
  • ultrassonografia abdominal
  • ultrassonografia renal
  • tomografia computadorizada (TC) ou ressonância nuclear magnética (RNM) craniana
Detalhes completos

Algoritmo de tratamento

AGUDA

sem depleção de volume

sem depleção de volume, mas que não respondeu ao manejo conservador

com depleção de volume

Colaboradores

Autores

Jeffrey D. Quinlan, MD, FAAFP

Professor and Chair

Family Medicine

Carver College of Medicine

University of Iowa

Iowa City

IA

Disclosures

JDQ declares that he has no competing interests.

Peer reviewers

Sarah Jorgensen, DO

Faculty Physician

Family Medicine Residency

Naval Hospital Jacksonville

FL

Disclosures

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

Disclosures

YTJ declares that he has no competing interests.

D. Ashley Hill, MD

Associate Director

Department of Obstetrics and Gynecology

Florida Hospital

Orlando

FL

Disclosures

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.

References

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.

Key articles

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

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

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

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].Full text

Reference articles

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

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    • Colecistite
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  • Guidelines

    • The management of nausea and vomiting in pregnancy and hyperemesis gravidarum
    • Antenatal care
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  • Patient information

    Enjoo matinal: perguntas a fazer ao seu médico

    Enjoo matinal

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