ABSTRACT
In the past, draconian regimes of intensive bed rest were prescribed for threatened miscarriage, but these have never been shown to be of definite value. Many women still feel that they should be advised to rest and, if they do miscarry, they may feel guilty that they have not rested enough. No hard and fast rules can be followed, but bed rest at home should not be at the exclusion of a visit to hospital for an ultrasound scan, where it might be discovered that the fetus is already dead. The best advice is probably found in A Guide to Effective Care in Pregnancy and Childbirth:
Vomiting is a very common symptom, especially early in pregnancy. It usually requires no treatment and resolves spontaneously. Hyperemesis gravidarum is a pathological state of vomiting, which can lead to severe disruption of the maternal systems, brain damage and death. The boundary line between these two clinical pictures can be difficult to draw. Moreover, the unfortunate association of vomiting in pregnancy with psychological and socio-psychological disorders has led to such problems being branded as ‘all in the mind’ and women with severe hyperemesis are often managed in a half-hearted way, on the basis that their illness is really psychological.
