ABSTRACT
Oesophageal tears (Mallory Weiss syndrome) and haematemesis may also occur in women with severe and persistent vomiting. A sliding scale course of steroids has been used with encouraging results in uncontrolled studies. In the very worst cases, termination of pregnancy may be considered if the woman becomes malnourished and dehydrated such that there are signs of major organ failure. Some studies have found that a diet with a high total fat content, particularly saturated fat, increases the risk of severe hyperemesis. It is, therefore, important that midwives encourage women to eat a well-balanced
A small proportion of women (0.3-2 per cent) who experience nausea and vomiting will develop a more serious condition known as hyperemesis gravidarum, which requires urgent medical referral. In this situation, admission to hospital is advised and antiemetics, such as metoclopramide or prochlorperazine, are prescribed. In addition, intravenous hydration support should be administered as long as the woman is vomiting. In the severest cases, total parenteral nutrition (TPN) is given, and parenteral B complex
diet containing all the food groups in adequate proportions prior to conception/in early pregnancy in order to reduce the incidence of this disorder.
