• Very common

• Symptoms 4th-7th week after last period

• most women ease by 12th week

• hyperemesis gravidarum

  • persistant vomiting

  • weight loss

  • ketouria

  • electolyte abnormal

evaluaiotn

• MSU

• USS

  • exclude trophoblastic disease/multiple preg

• TSH

• electrolytes and LFTs

Alternative therpaies

• Ginger

• Pyridoxine (vit b6)

  • 25-50mg tds

  • fully subs

• Acupressure

  • inside of forearm 3 fingerbreadths above wrist

Pharmacological therapyies

• metoclopramide

• phenthiazines

  • prochlorperazine

• Antihistamines

• ONdansetron = consider

• Steroids limited to women with intractable N&V