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Hyperemesis gravidarum — DRCOG MCQ

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HardEarly PregnancyHyperemesis gravidarumDRCOG

A woman at 10 weeks has severe vomiting, ketonuria and confusion after several days of poor intake. She is admitted for intravenous fluids. What is the most appropriate management?

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Correct answer: B — Give thiamine before dextrose-containing fluids

Prolonged vomiting and poor intake create risk of thiamine deficiency and Wernicke encephalopathy. Give thiamine before dextrose-containing fluids, alongside rehydration, electrolyte correction and appropriate antiemetics.

Reference: RCOG Green-top 69: Nausea and vomiting of pregnancy: https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/the-management-of-nausea-and-vomiting-of-pregnancy-and-hyperemesis-gravidarum-green-top-guideline-no-69/