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nausea%20-and-%20vomiting%20in%20pregnancy
NAUSEA & VOMITING IN PREGNANCY
Treatment Guideline Chart
Nausea and vomiting in pregnancy (NVP), commonly known as "morning sickness", affects 50-90% of pregnant women.
In most women, the condition manifests between the 4th-7th week after the last menstrual period and resolves by the 16th-20th week of gestation.
It manifests in a spectrum of severity from mild nausea to very rare life-threatening symptoms.
The etiology is multifactorial.
The pregnant woman's sense of well-being and her daily activities are greatly affected by nausea and vomiting; the physical and emotional impact often leads to anxiety and worry about the effect of the symptoms on the fetus and reduced job efficiency.

Nausea%20-and-%20vomiting%20in%20pregnancy Diagnosis

History

  • Determine the timing of the onset and the duration of nausea and vomiting in pregnancy (NVP), the amount of vomiting and retching per day, and existence of chronic conditions even before pregnancy
    • Inquire regarding abdominal pain, urinary symptoms, infection including chronic H pylori infection, or drug use
  • Severity of NVP during the 1st trimester can be assessed using the Pregnancy-Unique Quantification of Emesis (PUQE) score 
    • The scores obtained are associated with quality of life measurements

Physical Examination

  • Check vital signs, signs of dehydration or muscle wasting, thyroid gland enlargement, abdominal and neurological examination

Laboratory Tests

Diagnostic Tests

  • Blood chemistry [serum electrolytes, TSH, blood urea nitrogen (BUN), creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), bilirubin, amylase, lipase, phosphorus, magnesium, glucose], complete blood count (CBC), urinalysis and urine ketones are directed towards confirming the findings of the history and physical exam
  • Ultrasound may exclude molar or multiple pregnancy
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