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Hyperemesis gravidarum — DRCOG MCQ

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HardAntenatal CareHyperemesis gravidarumDRCOG

A 26-year-old woman at 18 weeks' gestation has persistent nausea and vomiting, weight loss of 4 kg and ketonuria on dipstick. She has tried oral cyclizine but cannot keep fluids down. Her pulse is 112/min and mucous membranes are dry. What is the most likely diagnosis?

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Correct answer: D — Hyperemesis gravidarum

Weight loss, ketonuria, tachycardia and inability to tolerate fluids support hyperemesis gravidarum rather than ordinary nausea of pregnancy. Viral gastroenteritis may cause vomiting but would not usually produce this persistent pregnancy-specific pattern with significant weight loss. The pearl is that dehydration and functional impairment are what move nausea and vomiting into hyperemesis territory.

Reference: RCOG Green-top Guideline No. 69; NICE NG201