Скачать или смотреть Hyperemesis gravidarum

Hyperemesis gravidarum has a reported incidence of approximately 0.3–3% of pregnancies. Without treatment, refractory hyperemesis gravidarum can result in dehydration, electrolyte deficiencies, and severe nutritional deficiencies, resulting in significant maternal morbidity. The overall goals of inpatient management of refractory hyperemesis gravidarum are the resumption of oral intake to an adequate level to maintain hydration and nutrition, including the ability to tolerate oral pharmacotherapy. Patients initially are stabilized with rehydration and electrolyte repletion. There are numerous pharmacotherapeutics available that can be administered intravenously to control symptoms when oral intake is not an option. However, despite maximizing typical antiemetics, there will be cases refractory to these medications, and alternative pharmacotherapeutics and nutrition-support modalities must be considered. Mirtazapine, olanzapine, corticosteroids, and gabapentin are examples of alternative pharmacotherapeutics, and enteral and parenteral nutrition are alternative therapies that can be used when oral intake is not tolerated for prolonged time periods with ongoing weight loss. In refractory cases of hyperemesis gravidarum, the risks and benefits of these alternative forms of management must be considered, along with the risks of undertreated hyperemesis gravidarum and the overall effect of hyperemesis gravidarum on patients’ quality of life.

#hg #nvp #hyperemesis #hyperemesisgravidarum #nauseaandvomitingofpregnancy #morningsickness

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I am a double board certified ObGyn and Maternal-Fetal Medicine specialist focusing on the care of people with maternal and/or fetal complications of pregnancy. I discuss hot topics related to fertility, pregnancy and the postpartum period, and do a little myth-busting and fact-checking to keep things real! Not only am I a doc, but I was also a patient who had infertility, a high-risk twin pregnancy and preterm delivery, and NICU stay at age 43 as a first-time mom--so I GET IT! Leave requests for new topics in comments!
 
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