Evacuation of bowel: Bowel wash may be given in severe cases; enema can be given when condition improves. Laxative by mouth at bed time is given in mild cases.
Hygiene of the patient: Oral hygiene is very important. After each vomit, the mouth should be washed and cleansed to prevent parotitis especially in severe cases.
Hyperemesis chart: It should be maintained for moderate to severe types noting the following: number of vomits; dehydration; total intake and output of fluid per 24 hours; blood pressure recordings; bowel; urine should be tested daily particularly for acetone, albumin, bile, and chloride. Blood biochemistry should be done. The fundus oculi should be examined. Electrocardiography is indicated to detect potassium deficiency. Progress on treatment is assessed mainly on clinical features.
N.B. the essential treatments of hyperemesis gravidarum are hospitalization, sedative, saline, glucose and vitamins.
Prognosis: With conservative treatment, vast majority of patients improve. It is interesting how the patients who were vomiting persistently at home, quickly stop vomiting and improve on isolation in a hospital bed. Early admission to hospital prevents development of severe type, leading to death.
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