Hyperemesis Gravidarum

Hyperemesis gravidarum is a condition of pregnancy associated with severe nausea and vomiting typically during early pregnancy. Morbidity and mortality of mother or fetus can be due to severe dehydration, electrolyte disturbance, nutrition deficit, or even psychologic distress. The systemic presence and fluctuations of pregnancy hormones, especially human chorionic gonadotropin, are most commonly associated with hyperemesis gravidarum; however, these hormonal changes affect women differently. The diagnosis of hyperemesis gravidarum is typically clinical but can be augmented by clinical decision rules or laboratory studies. Significant ketone values in the blood or urine can signify concerning hyperemesis gravidarum cases. Emergency management of hyperemesis gravidarum focuses on management of nausea/vomiting with antiemetic agents, electrolyte management, and fluid replacement. Ultimately, the patient needs proper fluid balances and nutrition for optimal outcomes.