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Hyperemesis gravidarum

  • Ddx

    • GTDs (hydatidiform mole, choriocarcinoma), rupture ectopic pregnancy, gallstone, gastroenteritis, HELLP syndrome
  • Labs

    • CBC, chem
    • r/o GTD
      • hCG
      • f/u US if hCG > 100,000
    • UA (ketonuria)
  • Tx

    • IV 5% dextrose in NS
    • antiemetics
      • metoclopramide 10 mg IV
      • promethazine 25 mg IV (pregnancy class C, but widely used)
      • odansetron 4 mg IV
    • OBGyn consult if refractory

  • Print | Citations

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