Severe nausea and vomiting in pregnancy - Hiperemezis gravidarium - Diagnosis

Laboratory studies:
-urinoanaliza to assess ketones, a sign of starvation ketones may be harmful to fetal development
serum electrolytes and ketones, to assess sodium and potassium, metabolic alkalosishyperchloraemic identification, assessment of fluid status and renal fucntiei
and bilirubin, liver enzymes are elevated in 50% of patients with hiperemeza,transaminita moderate emesis resolves after solving but can be a sign of liver damageand Background
-amylase level is elevated to approximately 105 patients, combined with lipase, amylase increase specificity of diagnosis of pancreatitis
-evaluation of TSH, free tyrosine indicate a transient hyperthyroidism
urine-culture may indicate urinary frequency ifectie in pregnancy and can be associatedwith nausea and vomiting
high-calcium level in some cases may be associated with hyperparathyroidismhiperemeza
high-hematocrit may be due to volume contraction
-Hepatitis A, B, C may be clinically confused with emesis.

Imaging Studies:
obstetrics, ultrasound is usually indicated for patients with suspected multiple pregnancies or trophoblastic disease.

The differential diagnosis is made ​​with the following conditions: appendicitis, biliarydisease, esophagitis, fatty liver, diabetic ketoacidosis, gastroenteritis, hyperthyroidism,nephrolithiasis, acute pancreatitis, irritable bowel syndrome, peptic ulcer disease,gastrointestinal reflux disease, eclampsia, drug toxicity, disturbance Eating, migraines,gastroparesis, ovarian torsion, psychological disorders, brain tumors, vestibular lesions.