Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- primeiro trimestre da gestação
- perda de peso de >5%
Other diagnostic factors
- ausência de nódulos/aumento da tireoide
- membranas mucosas ressecadas
- tontura postural
- taquicardia
- hipotensão
- respiração cetótica
Risk factors
- 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
Diagnostic investigations
1st investigations to order
- diagnóstico clínico
Investigations to consider
- 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
Treatment algorithm
sem depleção de volume
sem depleção de volume, mas que não respondeu ao manejo conservador
com depleção de volume
Contributors
Authors
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.
References
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
- Gastroenterite viral
- Intoxicação alimentar
- Colecistite
More DifferentialsGuidelines
- The management of nausea and vomiting in pregnancy and hyperemesis gravidarum
- Antenatal care
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