Hyperemesis Gravidarum Clinical Presentation

Updated: Jan 04, 2017
  • Author: Dotun A Ogunyemi, MD; Chief Editor: Christine Isaacs, MD  more...
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Presentation

History

The defining symptoms of hyperemesis gravidarum are gastrointestinal in nature and include nausea and vomiting. Other common symptoms include ptyalism (excessive salivation), fatigue, weakness, and dizziness.

Patients may also experience the following:

  • Sleep disturbance
  • Hyperolfaction
  • Dysgeusia
  • Decreased gustatory discernment
  • Depression
  • Anxiety
  • Irritability
  • Mood changes
  • Decreased concentration

When obtaining history from the patient, discuss present symptoms. Obtain information pertaining to the timing, onset, severity, pattern, and alleviating and exacerbating factors (eg, relationship to meals, medications, prenatal vitamins, stress, other triggers).

A thorough review of systems for any symptoms that might suggest other gastrointestinal, renal, endocrine, and central nervous system disorders is vital.

Review past medical history, placing emphasis on past medical conditions, surgeries, medications, allergies, adverse drug reactions, family history, social history (including support system), employment, habits, and diet.

Obtaining a thorough gynecologic history of symptoms, such as vaginal bleeding or spotting, past pregnancies, past use of oral contraceptives, and response to oral contraceptives used, is important.

Next:

Physical

The physical examination is usually unremarkable in patients with hyperemesis gravidarum. The physical examination findings may be more helpful if the patient has unusual complaints suggestive of other disorders (eg, bleeding, abdominal pain).

Pay attention to the vital signs, including standing and lying blood pressure and pulse, volume status (eg, mucous membrane condition, skin turgor, neck veins, mental status), general appearance (eg, nutrition, weight), thyroid examination findings, abdominal examination findings, cardiac examination findings, and neurologic examination findings.

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