Hyperemesis gravidarum (HG) is characterized by unrelenting nausea and vomiting in pregnancy and may be accompanied by weight loss, electrolyte abnormalities, and dehydration. Prompt recognition and early efforts to control symptoms are essential to limiting progression of disease. Fluid and electrolyte repletion, as well as pharmacologic control of symptoms, is the mainstay of acute HG management. Pharmacologic therapy includes dopamine antagonists, selective serotonin inhibitors, and H1 antagonists. For patients with prolonged symptoms, treatment should include supplemental folate and thiamine. Admission is reserved for patients with significant electrolyte abnormalities or severe symptoms refractory to pharmacologic intervention.
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