Differential diagnosis of Hyperemesis gravidarum:

Ans. is a, b and c Nausea and vomiting of pregnancy commonly termed morning sickness' is a normal phenomenon in pregnancy, occurring in about 70% of all pregnancies. in most women, it is limited to the first trimester. but a few may continue to have symptoms throughout pregnancy. Hyperernesis gravidarum is the other end of the spectrum characterised by severe nausea and intractable vomiting sufficient to interfere with nutrition. Risk Factors : - Maternal age > 35 years High body weight. Nulliparity H. mole - Cigarette smoking Twin pregnancy - Fetal loss Positive family history - Unplanned pregnancy Clinical features are due to : -- Dehydration Stareation Ketoacidosis Vomiting associated with Pregnancy (unr-lated to pregnancy) Medical W * intestinal infestation * Urinary tract infection * Hepatitis/Pancreatitis * Keto-acidosis of diabetes * Uraemia * CNS disorder Surgical * Appendicitis *Peptic ulcer reflux *Intestinal obstruction * Cholecystitis/Cholelithiasis Gynaecological * Twisted ovarian tumour * Red degeneration of fibroid Management : Mild to moderate Nausea and Vomiting of Pregnancy - usually needs no treatment except reassurance and frequent small meals. Vitamin B5 alone or with doxylamine is safe and can be considered. Vomiting associated with Pregnancy (unr-lated to pregnancy) Medical W * intestinal infestation * Urinary tract infection * Hepatitis/Pancreatitis * Keto-acidosis of diabetes * Uraemia * CNS disorder Surgical * Appendicitis * Peptic ulcer reflux * Intestinal obstruction * Cholecystitis/Cholelithiasis Gynaecological * Twisted ovarian tumour * Red degeneration of fibroid