What are the symptoms in the patient with hyperemesis gravidarum?
Hyperemesis gravidarum usually occurs in the first pregnancy and in the early months of pregnancy. The onset is insidious. Early stage (only the activities are limited without evidence of dehydration or starvation) • Vomiting occurs independent of food, spread throughout the day and everything taken in is rejected. The vomiting consists of bile stained fluid or only food. • Normal activities are curtailed. • Nutrition of the mother is good. • On examination, she looks well and no abnormality is detected • Blood investigations and urine analysis is normal Late stage( Evidences of dehydration and starvation are present) • Vomiting is increased in amount and in frequency. Retching and nausea persist in between vomiting. The vomitus may be coffee ground or even contain blood. • Urinary quantity is diminished • Constipation, at times diarrhea. • Epigastric pain • The patient is confined to bed • Mental apathy, restlessness, sleeplessness, convulsion or even coma. • Mental confusion with los
