Materiały źródłowe

• #1 Nausea and Vomiting of Pregnancy

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3676933/

  Nausea and vomiting are common experiences in pregnancy, affecting 70-80% of all pregnant women. […] This article reviews the epidemiology, pathology, diagnosis, outcomes, and treatment of NVP and HG. […] Despite popular use of the term morning sickness, NVP persists throughout the day in the majority of affected women and has been found to be limited to the morning in less than 2% of women. […] While dehydration and orthostasis can occur in women with HG, most women with NVP have normal vital signs and a benign physical exam. […] Other than a pregnancy test, no specific laboratory studies are recommended for the diagnosis of NVP. […] HG is a clinical diagnosis based on symptoms and the exclusion of other conditions. Like NVP no specific testing is needed to diagnose HG; however, ultrasound of the abdomen and pelvis may be helpful in excluding other causes such as gallbladder disease, hydatidiform mole and in assessing for multiple gestations.

• #1 Morning sickness: Treatments, prevention, and when it starts

  https://www.medicalnewstoday.com/articles/179633

  If a person is pregnant and experiencing nausea and vomiting without another underlying cause, the diagnosis of morning sickness is typically straightforward. […] Diagnosing hyperemesis gravidarum is more complicated. A doctor typically looks for: prolonged nausea and vomiting, a pre-pregnancy weight loss of more than 5%, an electrolyte imbalance, dehydration. […] The doctor may also order an ultrasound scan to confirm the number of fetuses and check for any underlying health issues that could contribute to the nausea and vomiting.

• #1 Morning sickness – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/morning-sickness/symptoms-causes/syc-20375254

  Morning sickness is feeling like throwing up, also called nausea, and throwing up, also called vomiting, that occurs during pregnancy. […] Many people have morning sickness, especially during the first three months of pregnancy. […] Morning sickness is most common during the first three months of pregnancy. It typically starts before nine weeks. Symptoms usually improve by the middle or end of the second three months of pregnancy. […] Contact your health care provider if: […] The cause of morning sickness is not known. Hormone changes might play a role. […] Mild nausea and vomiting of pregnancy usually won’t cause harm. […] If left untreated, severe nausea and vomiting can cause a lack of bodily fluids, a condition known as dehydration.

• #1 Hyperemesis Gravidarum – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/antenatal-complications/hyperemesis-gravidarum

  Hyperemesis gravidarum is severe nausea and vomiting during pregnancy that results in dehydration, weight loss, and ketosis. Diagnosis is clinical and by measurement of urine ketones, serum electrolytes, and renal function. […] Clinicians suspect hyperemesis gravidarum based on symptoms (eg, onset, duration, and frequency of vomiting; exacerbating and relieving factors; type and amount of emesis). Serial weight measurements can support the diagnosis. […] If hyperemesis gravidarum is suspected, urine ketones, thyroid-stimulating hormone, serum electrolytes, blood urea nitrogen (BUN), creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), magnesium, and phosphorus are measured. […] Hyperemesis gravidarum is severe nausea and vomiting during pregnancy that, unlike morning sickness, can cause weight loss, ketosis, dehydration, and sometimes electrolyte abnormalities. […] Determine severity by measuring serum electrolytes, urine ketones, BUN, creatinine, and body weight.

• #1 Diagnosis of Pregnancy – D. El-Mowafi

  https://www.gfmer.ch/Obstetrics_simplified/Diagnosis_of_pregnancy.htm

  Morning sickness: nausea with or without vomiting commences in the morning. It usually appears about 6 weeks after onset of the last menstrual period and usually disappears 6-12 weeks later. […] Morning sickness and urinary symptoms decrease. […] Pregnancy tests are positive, sonar and X-ray are diagnostic.

• #1 Hyperemesis Gravidarum – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532917/

  Hyperemesis gravidarum refers to intractable vomiting during pregnancy, leading to weight loss and volume depletion, resulting in ketonuria and/or ketonemia. There is no consensus on specific diagnostic criteria, but it generally refers to the severe end of the spectrum regarding nausea and vomiting in pregnancy. […] The evaluation should include urinalysis to check for ketonuria and specific gravity, in addition to a complete blood count and electrolyte evaluation. An elevation in hemoglobin or hematocrit may be due to hemoconcentration in the setting of dehydration. Significant dehydration may result in acute kidney injury as evidenced by elevated serum creatinine, blood urea nitrogen, and reduced glomerular filtration. […] There is no single accepted definition for hyperemesis gravidarum. However, it generally refers to extreme cases of nausea and vomiting during pregnancy. It is a clinical diagnosis. The criteria for diagnosis include vomiting that causes significant dehydration (as evidenced by ketonuria or electrolyte abnormalities) and weight loss (the most commonly cited marker for this is the loss of at least five percent of the patients pre-pregnancy weight) in the setting of pregnancy without any other underlying pathological cause for vomiting. Significant abdominal tenderness, pelvic tenderness, or vaginal bleeding should prompt a workup for alternative diagnoses.

• #1 Hyperemesis gravidarum – Wikipedia

  https://en.wikipedia.org/wiki/Hyperemesis_gravidarum

  Hyperemesis gravidarum is considered a diagnosis of exclusion. […] Diagnosis is usually made based on the observed signs and symptoms. […] Criteria for diagnosing HG in a patient generally includes vomiting that results in significant dehydration and weight loss (at least 5% of the patients pre-pregnancy weight). […] Urinalysis is usually performed and blood samples may be taken to check for ketonuria, electrolyte imbalances, and complete blood counts, all of which could indicate HG or prompt an alternative diagnosis. […] Women experiencing hyperemesis gravidarum often are dehydrated and lose weight despite efforts to eat. […] Similar to the onset of standard bouts of morning sickness, the nausea and vomiting with hyperemesis typically starts between 5 and 6 weeks into pregnancy.

• #1 The Management of Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum (Green-top Guideline No.69) | RCOG

  https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/the-management-of-nausea-and-vomiting-of-pregnancy-and-hyperemesis-gravidarum-green-top-guideline-no-69/

  The guideline provides updated evidence-based or best clinical practice information regarding the diagnosis and subsequent management of nausea and vomiting in pregnancy (NVP) and hyperemesis gravidarum (HG) across community, ambulatory day care and inpatient settings. […] NVP is defined as the symptom of nausea and/or vomiting during pregnancy when onset is prior to 16 weeks of gestation and where there are no other causes. […] HG is a severe form of NVP, which affects between 0.3% and 3.6% of pregnant women, interfering with quality of life and the ability to eat and drink normally.

• #1 Nausea and Vomiting in Pregnancy | Doctor

  https://patient.info/doctor/nausea-and-vomiting-in-pregnancy-including-hyperemesis-gravidarum

  It concluded that referring to nausea and vomiting in pregnancy as simply 'morning sickness’ is inaccurate, simplistic and therefore unhelpful. […] These are only required if there is a possible alternative diagnosis or in the assessment of the well-being of mother and fetus. […] In primary care, investigations are usually not required, unless there is concern that the mother is not maintaining adequate fluid intake. […] In cases of hyperemesis gravidarum: renal function and electrolytes, LFTs, midstream urine (for infection and ketones) and ultrasound (exclude multiple or molar pregnancy). […] Most cases are mild and do not require treatment. […] However, persistent vomiting and severe nausea can progress to hyperemesis gravidarum if the woman is unable to maintain adequate hydration and fluid and electrolyte balance.

• #1 Hyperemesis Gravidarum: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/254751-overview

  Initial laboratory studies used in the evaluation of women with hyperemesis gravidarum should include the following: Urinalysis for ketones and specific gravity, Serum levels of electrolytes and ketones, Liver enzymes and bilirubin levels, Amylase/lipase levels, Thyroid stimulating hormone, free thyroxine levels, Urine culture, Calcium level, Hematocrit level, Hepatitis panel. […] The following imaging studies may be used to assess women with hyperemesis gravidarum: Obstetric ultrasonography: Usually warranted to evaluate for multiple gestations or trophoblastic disease, Upper abdominal ultrasonography: If clinically indicated, to evaluate the pancreas and/or biliary tree, Abdominal computed tomography scanning or magnetic resonance imaging: If appendicitis is suspected as a cause of nausea and vomiting in pregnancy.

• #1 Nausea and Vomiting of Pregnancy | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0615/p965.html

  In the absence of other physical findings, significant dehydration, with or without orthostasis, is consistent with hyperemesis gravidarum. […] If laboratory tests are ordered because of clinical suspicion that symptoms are not caused by straightforward nausea and vomiting of pregnancy, a basic approach should include a complete blood count; urinalysis; metabolic panel including transaminase levels; and measurement of thyroid-stimulating hormone, quantitative hCG, and amylase levels. […] A variety of safe and effective therapeutic options are available, and a multimodal approach to treatment is helpful.

• #1 Hyperemesis Gravidarum: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/254751-overview

  Hyperemesis gravidarum is the most severe form of nausea and vomiting in pregnancy. It is characterized by persistent nausea and vomiting not related to other causes that is associated with a measure of acute starvation, such as ketosis and weight loss (5% of prepregnancy weight). This condition may cause volume depletion, electrolytes and acid-base imbalances, nutritional deficiencies, and even death. Severe hyperemesis requiring hospital admission occurs in 0.3-3% of pregnancies. […] Physical examination in women with suspected hyperemesis gravidarum is usually unremarkable. Findings may be more helpful if the patient has unusual complaints suggestive of other disorders (eg, bleeding, abdominal pain). […] Scores from the Pregnancy-Unique Quantification of Emesis and Nausea (PUQE), a validated survey tool, have been found to be clinically useful, since the scores are associated with quality of life measurements.

• #1 Nausea and Vomiting of Pregnancy – Zero To Finals

  https://zerotofinals.com/obgyn/earlypregnancy/hyperemesis/

  Nausea and vomiting of pregnancy can be diagnosed based on a typical history. Nausea and vomiting needs to start in the first trimester, and other causes need to be excluded before making a diagnosis. […] Hyperemesis gravidarum is the severe form of nausea and vomiting in pregnancy. The RCOG guideline (2016) criteria for diagnosing hyperemesis gravidarum are protracted NVP plus: […] The severity can be assessed using the Pregnancy-Unique Quantification of Emesis (PUQE) score. This gives a score out of 15:

• #1 Nausea and vomiting in pregnancy | Safer Care Victoria

  https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/maternity/nausea-and-vomiting

  This guideline provides information and recommendations for the assessment, diagnosis, and management of nausea and vomiting in pregnancy (NVP), including the more severe form known as hyperemesis gravidarum (HG). […] Women should be asked about NVP at visits between 4 -16 weeks gestation. […] For women reporting substantial symptoms, severity should be assessed using an assessment tool. One validated assessment tool is the Motherisk Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) scoring index. […] Hyperemesis Gravidarum is a more severe subset of NVP, defined as all the following: Symptoms starting <16 weeks gestation, Severe nausea and/or vomiting (PUQE-24 ≥ 13), Inability to eat and/or drink normally, Strongly limiting daily activities. [...] Women with mild-moderate nausea and vomiting of pregnancy (PUQE-24 ≤12), where symptoms are not suspicious for HG or another diagnosis, do not need investigation. [...] Measure TSH in women with HG or NVP refractory to treatment, or in women with signs and/or symptoms of thyrotoxicosis. [...] Management of women who have Gestational hyperthroxinaemia is supportive with appropriate treatment of NVP; anti thyroid medications are not required.

• #1 Nausea and Vomiting of Pregnancy | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0615/p965.html

  Nausea and vomiting of pregnancy affects nearly 75% of pregnant women. […] Patients with nausea and vomiting of pregnancy should be evaluated for other causes, particularly if symptoms are unremitting or presentation is atypical. […] Women with hyperemesis gravidarum may require more aggressive interventions, including hospitalization, rehydration therapy, and parenteral nutrition. […] Hyperemesis gravidarum describes nausea and vomiting that is severe enough to cause fluid and electrolyte disturbances, and often requires hospitalization. […] In most pregnancies, nausea and vomiting is mild and self-limited. […] Women who have atypical presentations (e.g., onset of symptoms after nine weeks’ gestation, symptoms beyond the first trimester, severe symptoms, hyperemesis gravidarum) should be evaluated to exclude potentially serious causes.

• #1 Cannabis Hyperemesis Syndrome (CHS) | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/cannabinoid-hyperemesis-syndrome.html

  Many health problems can cause repeated vomiting. To make a diagnosis, your health care provider will ask you about your symptoms and your past health. They will also do a physical exam, including an exam of your belly. […] Your provider may also need more tests to rule out other causes of the repeated vomiting. Thats especially the case for tests that may signal a health emergency. Based on your other symptoms, these tests might include: […] CHS was only recently discovered. So some providers may not know about it. As a result, they may not spot it for many years. They often confuse CHS with cyclical vomiting disorder. That is a health problem that causes similar symptoms. A specialist trained in diseases of the digestive tract (gastroenterologist) might make the diagnosis. […] You may have CHS if all of the following are true for you:

• #1 Hyperemesis gravidarum: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001499.htm

  Morning sickness can most often be managed by avoiding foods that trigger the problem and drinking plenty of fluids when the symptoms decrease in order to stay hydrated. […] Morning sickness typically is mild, but persistent. It can begin between 4 and 8 weeks of pregnancy. It typically goes away by 16 to 18 weeks of pregnancy. […] Severe vomiting is harmful because it leads to dehydration and poor weight gain during pregnancy. […] Contact your provider if you are pregnant and have severe nausea and vomiting or if you have any of the following symptoms: Signs of dehydration, Unable to tolerate any fluids for over 12 hours, Lightheadedness or dizziness, Blood in the vomit, Abdominal pain, Weight loss of more than 5 pounds or 2.7 kilograms.

• #1 Morning sickness | March of Dimes

  https://www.marchofdimes.org/find-support/topics/pregnancy/morning-sickness

  Morning sickness is when you have nausea and vomiting during pregnancy. Even though its called morning sickness, it can happen any time of day. […] Morning sickness usually starts at about 6 weeks of pregnancy and goes away in the second trimester. […] If your morning sickness is severe or if it goes into your fourth month of pregnancy, tell your health care provider right away. […] Mild morning sickness doesnt harm you or your baby. But if nausea and vomiting becomes severe (called hyperemesis gravidarum), it can cause serious problems during pregnancy. You may need to stay in the hospital for treatment. […] If you have hyperemesis gravidarum, your provider may treat you with medicine to help relieve your nausea and vomiting. […] Yes. If you cant relieve morning sickness on your own or if you have severe nausea and vomiting of pregnancy, your provider may treat you with these medicines: Vitamin B6 and doxylamine. […] Talk to your provider before you take any medicine during pregnancy, even medicine to help treat morning sickness. […] But call your provider if: Your morning sickness continues into your 4th month of pregnancy.

• #1 Hyperemesis Gravidarum – Investigations – Antiemetics – TeachMeObGyn

  https://teachmeobgyn.com/pregnancy/early/hyperemesis-gravidarum/

  Hyperemesis gravidarum (HG) is diagnosed when there is prolonged and severe NVP with: […] More than 5% pre-pregnancy weight loss […] Dehydration, and […] Electrolyte imbalances. […] The investigations in nausea and vomiting or hyperemesis gravidarum can be divided into bedside tests, laboratory tests and imaging. […] Electrolyte levels are particularly important to monitor; as deranged levels are a hallmark of hyperemesis gravidarum. […] The diagnosis is made via history, examination and investigation. […] The management of HG involves antiemetics and rehydration. […] The severity of HG determines the most appropriate setting for management.

• #1 Hyperemesis Gravidarum: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/12232-hyperemesis-gravidarum

  Hyperemesis gravidarum is the medical term for severe nausea and vomiting during pregnancy. […] Hyperemesis gravidarum is sometimes called severe morning sickness. […] Hyperemesis gravidarum causes you to vomit several times per day. […] Symptoms of HG often last longer than morning sickness. […] Your healthcare provider will ask about your symptoms and medical history and perform a physical exam. […] Your provider might order blood and urine tests to check you for dehydration. […] If your vomiting is excessive and you become dehydrated, you might need to stay in the hospital. […] Treatment depends on the severity of your symptoms. […] The best thing you can do for hyperemesis gravidarum is to get treatment from your provider. […] Severe vomiting or being unable to keep food and liquids down isnt a normal part of pregnancy. […] Hyperemesis gravidarum is extreme morning sickness and causes you to vomit several times per day during pregnancy.

• #1 Morning Sickness: When It Starts, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/16566-morning-sickness-nausea-and-vomiting-of-pregnancy

  About 70% of women get morning sickness. […] If you have severe morning sickness, your obstetrician may want to treat you with medication or IV fluids. […] Tell your obstetrician if you feel symptoms of morning sickness. If they suspect hyperemesis gravidarum, they may order urine (pee) or blood tests. […] Women with severe morning sickness may need to be admitted to the hospital to receive IV fluids to restore hydration and medications to relieve nausea. […] Your healthcare provider may recommend taking vitamin B6 (also called pyridoxine) and doxylamine. […] Your obstetrician can prescribe medications to prevent nausea (also called antiemetics). […] Dont wait until vomiting becomes severe to call your obstetrician. Seeking care for morning sickness early in pregnancy can help prevent it from becoming more severe.

• #1 Morning Sickness: Nausea and Vomiting of Pregnancy | ACOG

  https://www.acog.org/womens-health/faqs/morning-sickness-nausea-and-vomiting-of-pregnancy

  Nausea and vomiting can become more of a problem if you cannot keep down food or fluids and begin to lose weight. […] Because hyperemesis gravidarum is difficult to treat and can cause health problems, experts recommend early treatment so that it does not become severe. […] If diet and lifestyle changes dont help, or if you have severe nausea and vomiting of pregnancy, you might need medical treatment. […] If your nausea and vomiting are severe or if you have hyperemesis gravidarum, you might need to stay in the hospital until your symptoms are under control. […] If you continue to lose weight, a feeding tube may be recommended to ensure that you and your fetus are getting enough nutrients.

• #1 What to Do About Morning Sickness and Nausea During Pregnancy

  https://www.whattoexpect.com/pregnancy/morning-sickness/

  Typical symptoms of morning sickness include: A nauseous, queasy feeling in the first trimester of pregnancy that many pregnant women liken to seasickness or car sickness […] A nausea that’s so strong it can lead to vomiting. Morning sickness itself doesn’t harm your baby. However, you should see your doctor if you: Can’t keep any foods or liquids down […] Are experiencing fever or flu-like symptoms. […] What causes pregnancy nausea and vomiting? No one knows for sure, though many experts blame pregnancy hormones. The pregnancy hormone hCG peaks around the time morning sickness is worst, and rising levels of estrogen and progesterone relax the muscles of the digestive tract and make digestion less efficient. And a 2023 study has found that a single hormone, known as GDF15, could be the primary cause of morning sickness during pregnancy. GDF15 is released by the fetus and also by various tissues in the body in response to infections and other forms of stress. Researchers learned that the amount of GDF15 detected in a woman’s bloodstream is linked to how severe her morning sickness is. Women with bad morning sickness had abnormally high levels of GDF15 in their systems.

• #1 HER Foundation – Do I Have Morning Sickness or HG?

  https://www.hyperemesis.org/who-we-help/mothers-area/get-info/do-i-have-morning-sickness-or-hg/

  Women often ask if they have hyperemesis gravidarum (HG) or just severe morning sickness. Early in pregnancy, it may be difficult to know because HG may develop gradually. If you find yourself dehydrated and/or losing weight rapidly (1-2 pounds [0.45-0.9 kgs.] a week or more) due to severe nausea and vomiting, find a health professional who understands HG management. […] Sometimes morning sickness will progress to HG due to ineffective or inadequate care. Delaying treatment over concerns of any possible risks to the mother and child increases the risks for known complications of HG to both from chronic dehydration and malnutrition. Further, many medications such as promethazine and Zofran (ondansetron) have been used for decades and research finds little if any increase in risk to the unborn child, even if taken early in pregnancy. […] Significant (>5% of your pre-pregnancy weight) weight loss and recurrent dehydration are classic signs of HG. […] Every woman with HG loses weight unless they are given IV nutrition and medications at the start of HG. Calculate the percentage you have lost to see if you should call your doctor.

• #1 Nausea (Vomiting): Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/primary-care/nausea-vomiting/treatment

  How is Nausea Diagnosed? […] To diagnose the cause of your nausea, your physician will typically perform a physical exam, inquire about your symptoms and medical history, and look for signs of dehydration. […] If necessary, your doctor may order tests to determine any underlying conditions that could be causing nausea and vomiting. These tests can include: […] Pregnancy test. Early pregnancy (morning sickness) is a common cause of chronic nausea. […] A primary care physician can offer peace of mind and treatment options, even for mild bouts of nausea. For cases of prolonged or unexplained nausea, a doctor can help determine the cause, prescribe medications, and give referrals to specialists if further care is necessary. […] The best way to avoid nausea and vomiting is to treat the cause. A primary care doctor can help find the trigger. […] Our expert primary care doctors at NewYork-Presbyterian will evaluate your nausea symptoms, work to find the underlying cause, and provide treatment options.

• #1

  https://www.health.nsw.gov.au/kidsfamilies/MCFhealth/Pages/hyperemesis-gravidarum.aspx

  If you have severe NVP or HG, your pregnancy care provider should do further tests, such as blood or urine tests. […] The results of the tests will help guide your treatment. […] HG is a real and debilitating medical condition, and it is important that you are listened to and get the treatment you need. […] Based on your responses to the questions, your health care provider will suggest how to manage your sickness. […] If you have mild or moderate feelings of nausea and vomiting you do not usually need any other tests, however you may be offered some treatment for your symptoms. […] Your pregnancy care provider will develop a treatment plan with you based on your symptoms and their severity. […] Sometimes the nausea and vomiting cannot be stopped completely. […] The aim of treatment is to reduce your symptoms enough to allow normal daily activities, especially eating and drinking.

• #2 Morning Sickness: When It Starts, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/16566-morning-sickness-nausea-and-vomiting-of-pregnancy

  About 70% of women get morning sickness. […] If you have severe morning sickness, your obstetrician may want to treat you with medication or IV fluids. […] Tell your obstetrician if you feel symptoms of morning sickness. If they suspect hyperemesis gravidarum, they may order urine (pee) or blood tests. […] Women with severe morning sickness may need to be admitted to the hospital to receive IV fluids to restore hydration and medications to relieve nausea. […] Your healthcare provider may recommend taking vitamin B6 (also called pyridoxine) and doxylamine. […] Your obstetrician can prescribe medications to prevent nausea (also called antiemetics). […] Dont wait until vomiting becomes severe to call your obstetrician. Seeking care for morning sickness early in pregnancy can help prevent it from becoming more severe.

• #2 Morning sickness Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/symptoms/morning-sickness

  Morning sickness is nausea and vomiting that can occur at any time of the day during pregnancy. […] Morning sickness is very common. Most pregnant women have at least some nausea, and about one third have vomiting. […] Morning sickness most often begins during the first month of pregnancy and continues through the 14th to 16th week (3rd or 4th month). Some women have nausea and vomiting through their entire pregnancy. […] The amount of morning sickness during one pregnancy does not predict how you will feel in future pregnancies. […] Contact your provider if: Morning sickness does not improve, despite trying home remedies. […] Your provider will do a physical examination, including a pelvic exam, and look for any signs of dehydration. […] Your provider may do the following tests: Blood tests including CBC and blood chemistry (chem-20) […] Urine tests […] Ultrasound.

• #2 Nausea (Vomiting): Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/primary-care/nausea-vomiting/treatment

  How is Nausea Diagnosed? […] To diagnose the cause of your nausea, your physician will typically perform a physical exam, inquire about your symptoms and medical history, and look for signs of dehydration. […] If necessary, your doctor may order tests to determine any underlying conditions that could be causing nausea and vomiting. These tests can include: […] Pregnancy test. Early pregnancy (morning sickness) is a common cause of chronic nausea. […] A primary care physician can offer peace of mind and treatment options, even for mild bouts of nausea. For cases of prolonged or unexplained nausea, a doctor can help determine the cause, prescribe medications, and give referrals to specialists if further care is necessary. […] The best way to avoid nausea and vomiting is to treat the cause. A primary care doctor can help find the trigger. […] Our expert primary care doctors at NewYork-Presbyterian will evaluate your nausea symptoms, work to find the underlying cause, and provide treatment options.

• #2 What is HG? | Pregnancy Sickness Support

  https://pregnancysicknesssupport.org.uk/get-help/what-is-hyperemesis-gravidarum/

  The pregnancy sickness spectrum ranges from mild nausea and vomiting (often called NVP) to Hyperemesis Gravidarum (HG). […] While up to 90% of pregnant women and people experience some level of nausea and vomiting in pregnancy (NVP), HG is a severe form of pregnancy sickness that sits at the extreme end of the pregnancy sickness spectrum. […] However, if you’re unable to keep anything down for long periods, are losing weight, or feel that your symptoms are severely impacting your daily life, this may be a sign of something more serious like Hyperemesis Gravidarum (HG). […] The Windsor definition (2021) characterizes HG as a condition that starts early in pregnancy, before a gestational age of 16 weeks, and is characterized by severe nausea and/or vomiting, inability to eat and/or drink normally and strongly limits daily activities.

• #2 Hyperemesis Gravidarum: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/254751-overview

  Hyperemesis gravidarum is the most severe form of nausea and vomiting in pregnancy. It is characterized by persistent nausea and vomiting not related to other causes that is associated with a measure of acute starvation, such as ketosis and weight loss (5% of prepregnancy weight). This condition may cause volume depletion, electrolytes and acid-base imbalances, nutritional deficiencies, and even death. Severe hyperemesis requiring hospital admission occurs in 0.3-3% of pregnancies. […] Physical examination in women with suspected hyperemesis gravidarum is usually unremarkable. Findings may be more helpful if the patient has unusual complaints suggestive of other disorders (eg, bleeding, abdominal pain). […] Scores from the Pregnancy-Unique Quantification of Emesis and Nausea (PUQE), a validated survey tool, have been found to be clinically useful, since the scores are associated with quality of life measurements.

• #2 Nausea and vomiting of pregnancy: Treatment and outcome – UpToDate

  https://www.uptodate.com/contents/nausea-and-vomiting-of-pregnancy-treatment-and-outcome

  NVP severity should be assessed at each patient encounter as the severity of symptoms, such as the frequency of vomiting, can vary from day to day. […] Although there is no standard definition of, or criteria for, diagnosis of hyperemesis gravidarum, these patients typically present with weight loss (more than 5 percent prepregnancy weight); clinical signs of dehydration and volume depletion (eg, tachycardia, orthostatic hypotension); laboratory abnormalities (eg, electrolyte, thyroid, and liver abnormalities; ketonuria); and nutritional deficiencies. […] The goals of treatment are to:

• #2 Morning Sickness: Causes, Treatments, and Prevention

  https://www.healthline.com/health/morning-sickness

  Urine tests can determine whether you’re dehydrated. […] Your doctor may order blood chemistry tests that include: complete blood count (CBC), comprehensive metabolic panel, comprehensive metabolic panel (Chem-20), to measure the electrolytes in your blood. […] Ultrasound uses sound waves to produce images of your baby. The doctor then uses these images and sounds to check that your baby is developing at a healthy rate.

• #2 Nausea and vomiting in pregnancy – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/999

  Diagnostic tests include clinical diagnosis and tests to consider such as CBC, basic metabolic panel, serum LFTs, serum BUN and creatinine, serum thyroid-stimulating hormone (TSH) and free thyroxine (T4), urinalysis, urine or serum ketones, fetal ultrasound with nuchal translucency, serum analytes, Helicobacter pylori breath test, urine culture, serum amylase and lipase, abdominal ultrasound, renal ultrasound, cranial CT or MRI.

• #2 Hyperemesis Gravidarum: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/hyperemesis-gravidarum

  Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting during pregnancy. […] Hyperemesis gravidarum (HG) is an extreme form of morning sickness that causes severe nausea and vomiting during pregnancy. It often requires hospital treatment. […] Morning sickness and HG are very different conditions. They have different complications and side effects. Its important to distinguish between these two conditions to properly treat symptoms. […] Your doctor will ask you about your medical history and your symptoms. A standard physical exam is enough to diagnose most cases. Your doctor will look for common signs of HG, such as abnormally low blood pressure or a fast pulse. […] Blood and urine samples may also be necessary to check for signs of dehydration. Your doctor might also order additional tests to rule out gastrointestinal problems as a cause of your nausea or vomiting. […] Unlike typical morning sickness, HG requires medical treatment. […] Treatment for HG depends on the severity of your symptoms. […] Sometimes, early treatment of morning sickness may lower your risk of developing HG.

• #2 Nausea and vomiting in pregnancy | Safer Care Victoria

  https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/maternity/nausea-and-vomiting

  This guideline provides information and recommendations for the assessment, diagnosis, and management of nausea and vomiting in pregnancy (NVP), including the more severe form known as hyperemesis gravidarum (HG). […] Women should be asked about NVP at visits between 4 -16 weeks gestation. […] For women reporting substantial symptoms, severity should be assessed using an assessment tool. One validated assessment tool is the Motherisk Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) scoring index. […] Hyperemesis Gravidarum is a more severe subset of NVP, defined as all the following: Symptoms starting <16 weeks gestation, Severe nausea and/or vomiting (PUQE-24 ≥ 13), Inability to eat and/or drink normally, Strongly limiting daily activities. [...] Women with mild-moderate nausea and vomiting of pregnancy (PUQE-24 ≤12), where symptoms are not suspicious for HG or another diagnosis, do not need investigation. [...] Measure TSH in women with HG or NVP refractory to treatment, or in women with signs and/or symptoms of thyrotoxicosis. [...] Management of women who have Gestational hyperthroxinaemia is supportive with appropriate treatment of NVP; anti thyroid medications are not required.

• #2 Hyperemesis Gravidarum Differential Diagnoses

  https://emedicine.medscape.com/article/254751-differential

  It is important to consider other diagnoses in cases of severe refractory nausea and vomiting during pregnancy, especially if the presentation is atypical or other symptoms are present. […] It is vital to fully inform patients of the available evidence regarding potential risks and benefits of all treatments administered for hyperemesis gravidarum, especially regarding the effects of medications on the fetus. If not emergently required, avoid the administration of drugs during the first 10 weeks of gestation if possible. […] Other conditions to consider in the differential diagnosis of patients with suspected hyperemesis gravidarum include the following: […] Diagnostic Considerations […] Hyperemesis gravidarum: Epidemiologic findings from a large cohort. […] Nausea and vomiting of pregnancy: an obstetric syndrome. […] ACOG Practice Bulletin: nausea and vomiting of pregnancy.

• #2 Morning sickness – Wikipedia

  https://en.wikipedia.org/wiki/Morning_sickness

  Morning sickness, also called nausea and vomiting of pregnancy (NVP), is a symptom of pregnancy that involves nausea or vomiting. Diagnosis should only occur after other possible causes have been ruled out. Abdominal pain, fever, or headaches are typically not present in morning sickness. […] Diagnosis should only occur after other possible causes have been ruled out. Abdominal pain, fever, or headaches are typically not present in morning sickness.

• #2 Cannabis Hyperemesis Syndrome (CHS) | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/cannabinoid-hyperemesis-syndrome.html

  Many health problems can cause repeated vomiting. To make a diagnosis, your health care provider will ask you about your symptoms and your past health. They will also do a physical exam, including an exam of your belly. […] Your provider may also need more tests to rule out other causes of the repeated vomiting. Thats especially the case for tests that may signal a health emergency. Based on your other symptoms, these tests might include: […] CHS was only recently discovered. So some providers may not know about it. As a result, they may not spot it for many years. They often confuse CHS with cyclical vomiting disorder. That is a health problem that causes similar symptoms. A specialist trained in diseases of the digestive tract (gastroenterologist) might make the diagnosis. […] You may have CHS if all of the following are true for you:

• #2 Morning sickness – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/morning-sickness/symptoms-causes/syc-20375254

  Morning sickness is feeling like throwing up, also called nausea, and throwing up, also called vomiting, that occurs during pregnancy. […] Many people have morning sickness, especially during the first three months of pregnancy. […] Morning sickness is most common during the first three months of pregnancy. It typically starts before nine weeks. Symptoms usually improve by the middle or end of the second three months of pregnancy. […] Contact your health care provider if: […] The cause of morning sickness is not known. Hormone changes might play a role. […] Mild nausea and vomiting of pregnancy usually won’t cause harm. […] If left untreated, severe nausea and vomiting can cause a lack of bodily fluids, a condition known as dehydration.

• #2 Hyperemesis gravidarum: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001499.htm

  Morning sickness can most often be managed by avoiding foods that trigger the problem and drinking plenty of fluids when the symptoms decrease in order to stay hydrated. […] Morning sickness typically is mild, but persistent. It can begin between 4 and 8 weeks of pregnancy. It typically goes away by 16 to 18 weeks of pregnancy. […] Severe vomiting is harmful because it leads to dehydration and poor weight gain during pregnancy. […] Contact your provider if you are pregnant and have severe nausea and vomiting or if you have any of the following symptoms: Signs of dehydration, Unable to tolerate any fluids for over 12 hours, Lightheadedness or dizziness, Blood in the vomit, Abdominal pain, Weight loss of more than 5 pounds or 2.7 kilograms.

• #2 Severe morning sickness: how to diagnose and treat | EurekAlert!

  https://www.eurekalert.org/news-releases/1040828

  Severe morning sickness in pregnancy, known medically as hyperemesis gravidarum, can negatively affect both maternal and infant health. […] A review published in CMAJ (Canadian Medical Association Journal) provides information to clinicians on the causes, diagnosis, and treatment of the condition. […] Management of hyperemesis gravidarum requires considerable health care resources, as it is a common reason for hospital admission and emergency department visits in the first trimester. […] Treatment is aimed at relieving symptoms and includes starting an antiemetic (anti-nausea) drug and other medications if the antiemetic is not effective. […] The authors note that there are many unanswered questions about how to prevent and manage hyperemesis gravidarum and that more research is needed.

• #2 Morning Sickness Remedies | Tips and Strategies for Relief

  https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/morning-sickness-remedies/

  Morning sickness is the nauseous feeling commonly experienced during around the 6th week of pregnancy. […] It can occur at any time of the day, and for most women, it seems to stop after the 12th week of pregnancy. […] Morning sickness is not harmful to you or your baby, but if you experience excessive vomiting and cannot manage to keep your food down, you may have hyperemesis gravidarum and lack essential nutrients and electrolytes. […] Inform your doctor when these symptoms appear and discuss possible treatment options. […] More than 50% of pregnant women experience morning sickness. […] Many doctors think morning sickness is a good sign because it means the placenta is developing well. […] Prenatal Vitamins can make nausea worse, mostly because of the extra iron. […] Talk with your health care provider about any supplements and treatments for morning sickness. […] If morning sickness is so severe that you are constantly throwing up and not keeping anything down, consult your health care provider about the possibility of having hyperemesis gravidarum.

• #2 Vomiting and morning sickness – NHS

  https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/vomiting-and-morning-sickness/

  Nausea and vomiting in pregnancy, often known as morning sickness, is very common in early pregnancy. […] Morning sickness is unpleasant, and can significantly affect your day-to-day life. But it usually clears up by weeks 16 to 20 of your pregnancy and does not put your baby at any increased risk. […] Unfortunately, there’s no hard and fast treatment that will work for everyones morning sickness. Every pregnancy will be different. […] If your nausea and vomiting is severe and does not improve after trying lifestyle changes, your GP may recommend a short-term course of an anti-sickness medicine, called an antiemetic, that’s safe to use in pregnancy. […] Antiemetics will usually be given as tablets for you to swallow. […] It’s thought hormonal changes in the first 12 weeks of pregnancy are probably one of the causes of morning sickness.

• #2

  https://www.health.nsw.gov.au/kidsfamilies/MCFhealth/Pages/hyperemesis-gravidarum.aspx

  If you have severe NVP or HG, your pregnancy care provider should do further tests, such as blood or urine tests. […] The results of the tests will help guide your treatment. […] HG is a real and debilitating medical condition, and it is important that you are listened to and get the treatment you need. […] Based on your responses to the questions, your health care provider will suggest how to manage your sickness. […] If you have mild or moderate feelings of nausea and vomiting you do not usually need any other tests, however you may be offered some treatment for your symptoms. […] Your pregnancy care provider will develop a treatment plan with you based on your symptoms and their severity. […] Sometimes the nausea and vomiting cannot be stopped completely. […] The aim of treatment is to reduce your symptoms enough to allow normal daily activities, especially eating and drinking.

• #3 What is HG? | Pregnancy Sickness Support

  https://pregnancysicknesssupport.org.uk/get-help/what-is-hyperemesis-gravidarum/

  The pregnancy sickness spectrum ranges from mild nausea and vomiting (often called NVP) to Hyperemesis Gravidarum (HG). […] While up to 90% of pregnant women and people experience some level of nausea and vomiting in pregnancy (NVP), HG is a severe form of pregnancy sickness that sits at the extreme end of the pregnancy sickness spectrum. […] However, if you’re unable to keep anything down for long periods, are losing weight, or feel that your symptoms are severely impacting your daily life, this may be a sign of something more serious like Hyperemesis Gravidarum (HG). […] The Windsor definition (2021) characterizes HG as a condition that starts early in pregnancy, before a gestational age of 16 weeks, and is characterized by severe nausea and/or vomiting, inability to eat and/or drink normally and strongly limits daily activities.

• #3 Hyperemesis Gravidarum – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532917/

  Hyperemesis gravidarum refers to intractable vomiting during pregnancy, leading to weight loss and volume depletion, resulting in ketonuria and/or ketonemia. There is no consensus on specific diagnostic criteria, but it generally refers to the severe end of the spectrum regarding nausea and vomiting in pregnancy. […] The evaluation should include urinalysis to check for ketonuria and specific gravity, in addition to a complete blood count and electrolyte evaluation. An elevation in hemoglobin or hematocrit may be due to hemoconcentration in the setting of dehydration. Significant dehydration may result in acute kidney injury as evidenced by elevated serum creatinine, blood urea nitrogen, and reduced glomerular filtration. […] There is no single accepted definition for hyperemesis gravidarum. However, it generally refers to extreme cases of nausea and vomiting during pregnancy. It is a clinical diagnosis. The criteria for diagnosis include vomiting that causes significant dehydration (as evidenced by ketonuria or electrolyte abnormalities) and weight loss (the most commonly cited marker for this is the loss of at least five percent of the patients pre-pregnancy weight) in the setting of pregnancy without any other underlying pathological cause for vomiting. Significant abdominal tenderness, pelvic tenderness, or vaginal bleeding should prompt a workup for alternative diagnoses.

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