Hello and welcome to the zero to finals podcast. My name is Tom and in this episode I'm going to be

going through nausea and vomiting of pregnancy. And you can find written notes on this topic at

zero to finals.com slash hypermysis or in the early pregnancy section of the zero definals obstetrics and gynecology book.

So let's get straight into it.

Nausea is a very common symptom in pregnancy, particularly early on.

Nausea and vomiting in pregnancy starts in the first trimester, peaking around 8 to 12 weeks of gestation.

The severe form of nausea and vomiting in pregnancy is called hyper-emesis gravidarum.

Hyper refers to lots, emesis refers to vomiting, and gravida refers to pregnancy.

Nausea and vomiting are normal during early pregnancy and symptoms usually start from

four to seven weeks are worst around 10 to 12 weeks and then resolve by 16 to 20 weeks.

However, the symptoms can persist throughout the pregnancy. The placenta produces

human corionic gonadotropin, or HCG, during the pregnancy, and it's this hormone that's

thought to be responsible for the nausea and vomiting. Theoretically, higher levels of HCG result in worse symptoms.

Nausea and vomiting are more severe in molar pregnancies and multiple pregnancies due to the

higher HCG levels.

It also tends to be worse in the first pregnancy and in obese or

overweight women. Let's talk about making the diagnosis. Nausea and vomiting of pregnancy can be

diagnosed based on a typical history. Nausea and vomiting needs to start in the first trimester and other causes need to

be excluded before making a diagnosis. Let's talk in more detail about hyper-emesis gravidarum.

Hyper-emesis gravodorum is the severe form of nausea and vomiting in pregnancy.

The criteria for diagnosing hypromesis gravodorum from the RCOG guideline from 2016

are protracted nausea and vomiting plus more than 5% weight loss compared with before pregnancy, dehydration and

...