The last patient I had with this, for the 2nd time as it was the same
problem with an earlier pregnancy, was oriental. After some iv inpatient
care she was managed with a thin NG tube and continuous enteral feeding
to approach 2 l /day, progressing to nighttime only. Although
cumbersome, it was quite easy for her to manage on her own, less
invasive than home iv therapy, and no nasty drugs were being given to an
early gestation pregnancy. Her thyroid indices were also off the chart,
with no symptoms or persistance of thyroid difficulties post-partum.
At the time, about 5 years ago, had been able to locate several
references in Medline reporting enteral therapy of hyperemesis
gravidarum.
--
Mark Joyce, M.D. 403.239.3291 Calgary Canada
Adrian Midgley wrote:
>
> Mid twenties lady 14 weeks pregnant now.
> Too much vomiting, dehydration, ketones.
>
> Admitted twice, last time given 4 litres of iv fluid over about 24
> hours, discharged with the ketones reduced to a trace, and with some
> Amoxycillin.
>
> Tried Stemetil, Buccastem, Metoclopramide.
>
> Scan reported as one baby, nothing else.
>
> Questions
> Any other drugs particularly worth trying? Tablets are not a
> starter this evening, needs to be parenteral or rectal.
>
> If my local Obs and Gynae people chuck her out again having
> "rehydrated" her with 30% over her normal fluid requirement for a
> day, shall I set up a drip at home, or refer her to the physicians?
> I reckon she is probably 3 litres short still.
>
> --- OffRoad 1.9r registered to Adrian Midgley
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