Nausea-vomiting in pregnancy ( NVP )

Typically begins by 4th week and disappears by the 16th Peaks at approx 9 th week 75-80 % of pregnant experience this♦ varying intensity♦ various length of time Symptoms subside by 20th week in 90 % cases About 0.3 % - 1 % develop hyperemesis gravidarum ( HG )Hyperemesis Gravidarum is severe form of NVP- requires hospital admission. Diagnosis is on basis of the triad -♦ 5 % pre-pregnancy weight loss♦ dehydration♦ electrolyte imbalanceHG can be life threatening if not treated promptly and can ↑ the risk of fetal loss , preterm birth , LBWPrevious HG- advice risk of recurrence in future pregnancies NVP can have sig impact on physical and emotional health- impact can be comparable to those undergoing cancer chemotherapy Hospitalization for hyperemesis occurs in less than 1 % of pregnant women

Aetiology- Fetoprotective ( embryoprotection ) Genetic Biochemical Immunological BiosocialRising levels of hCG- ie conditions with ↑↑ levels of hCG as♦ trophoblastic dis♦ multiple pregnancyare associated with ↑ severity of NVP Ongoing work to study interaction of TSH suppression and hCG○ hCG is the thyroid stimulator of pregnancy and biochemical hyperthyroidism is seen commonly in HG Link between hCG and estradiol Female gender of the fetus associated...