Last reviewed: 9 Mar 2025
Last updated: 01 Apr 2025
Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- first trimester of pregnancy
- weight loss of >5%
Other diagnostic factors
- absence of thyroid enlargement/nodules
- dry mucous membranes
- postural dizziness
- tachycardia
- hypotension
- ketotic breath
Risk factors
- family history of hyperemesis gravidarum
- previous history of NVP
- multiple gestation or increased placental mass
- gestational trophoblastic disease
- other causes of increased placental mass
- female fetus
- history of motion sickness
- history of migraine headache
Diagnostic investigations
Investigations to consider
- FBC
- basic metabolic panel
- serum LFTs
- serum urea 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
Treatment algorithm
Contributors
Authors
Jeffrey D. Quinlan, MD, FAAFP
Professor and Chair
Family Medicine
Carver College of Medicine
University of Iowa
Iowa City
IA
Disclosures
JDQ declares that he has no competing interests.
Peer reviewers
Sarah Jorgensen, DO
Faculty Physician
Family Medicine Residency
Naval Hospital Jacksonville
FL
Disclosures
SJ declares that she has no competing interests.
Yosra Tahir Jarjees, MD
Assistant Professor
Head of Department of Obstetrics and Gynecology
Mosul College of Medicine
Mosul
Iraq
Disclosures
YTJ declares that he has no competing interests.
D. Ashley Hill, MD
Associate Director
Department of Obstetrics and Gynecology
Florida Hospital
Orlando
FL
Disclosures
DAH declares that he has no competing interests.
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