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Hyperemesis Gravidarum
Hyperemesis Gravidarum
Chief Complaint
Vomiting
OBSTETRIC HISTORY
G1P0 LMP: March 1, 2011 AOG : 17 weeks 5 days EDD: December 8, 2011
Menstrual History
Menarche: 10 years old Coitarche: 15 years old Menstrual cycle: 28-30 day cycle Duration: 3-4 days Using 3-4 pads fully soaked
Family History
No heredofamilial diseases.
Social History
Non smoker Non alcohol beverage drinker
Review of Systems
General : (-)Weight loss (42kg to 41kg), (-) Fever, (-) Chills (+) weakness (-) anorexia Cardio-Respi: (-)Chest pain, (-)Dyspnea (-) Hemoptysis (-)Cough, (-) Palpitations, (-)Edema GIT: (-)Dysphagia, (-) Heartburn, (-) Indigestion (+) Loss of appetite (-) Diarrhea (-)Constipation
Physical Examination
BP: 110/70 PR: 80 bpm RR: 16 cpm Temp: Afebrile
GS: Conscious, coherent, NICRD HEENT: AS, PPC, (+) sunken eyeballs Heart: AP, normal rate and rhythm, (-) murmur Extremities: Full ROM
Physical Examination
Abdomen: Globular with inverted umbilicus (-)straie gravidarum (-) linea nigra (-) tenderness in all 4 quadrants FH bet symphysis pubis and umbilicus Auscultation: normoactive bowel sound; FHT=NA Leopolds Maneuver: NA
Physical Examination
External Genitalia: Adequate hair distribution, no mass or lesion in the labia, perineum and anus
Clinical Pelvimetry Flat, soft uterus enlarged to 16-18 weeks size, no contraction, (-) AMT
Admitting Diagnosis
G1P0 PU 17w 5d AOG NIL Hyperemesis Gravidarum
Diagnostic Studies
Sodium Potasium Chloride 135 3.3 95 135 145 3.5 5.1 97 - 107
Diagnostic Studies
RBC Hgb Hct MCV MCH MCHC 5.02 x10 ^12/L 139 g/L 0.41% 82.3 fL 27.7 pg 33.7% 4.2 5.4 120 160 0.36 0.47 80 96 27-31 32 36
RDW Platelet
WBC Neutrophils Lymphocytes Basophils Eosinophils Monocytes
14.7 Adequate
13 0.8876 0.063 0.001 0.004 0.045
11.6 14.6
5 10 0.500 0.700 0.200 0.700 0.000 - .0200 0.000 - 0.600 0.020 - 0.090
Diagnostic Studies
Color Transparency Reaction Specific Gravity WBC RBC Epithelial cell Dark Yellow Turbid 8.0 1.010 3 10 0.3 Few
Albumin Sugar
Crystals
Trace Negative
Amorphous phosphate: Many
GASTRITIS/PUD
PREECLAMPSIA/HTN
LIVER DISEASE
Wernickes Encephalopathy
(Thiamine deficiency)
Vitamin K deficiency : maternal coagulopathy