In this episode of The Good GP, host Dr Maria Li speaks with Dr Katherine Wyld, an obstetric physician and endocrinologist, about hyperemesis gravidarum (HG). Outlining the distinction between common nausea and vomiting in pregnancy and the more severe and debilitating hyperemesis gravidarum.

Dr Wyld discusses the prevalence of HG, affecting about 1% of pregnancies, and its risk factors such as the history of HG and multiple gestations. She reviews tools for assessment, including the PUQE score, and says the need for clinical judgement, particularly where weight loss and electrolyte abnormalities are present.

Discussing management strategies as well; starting with single agents for mild cases, but initiating multiple antiemetics and supportive care early for moderate to severe cases. Dr Wyld covers the safety of first-line medications, as well as practical prescribing tips, monitoring frequency, and the importance of regular dosing.

Providing guidance on when to refer or escalate care, including red flag symptoms and criteria for hospital admission. They also talked about the mental health impact of HG, the importance of patient education and support, and assurance regarding typical pregnancy outcomes for most women with HG.

Links & Resources:

• Summary of nausea & vomiting and Hyperemesis, including medication list: SOMANZ-Management-of-NVP-Position-Statement-Updated-Oct-2023-FINAL-1.pdf

• Patient information sheets (including PUQE score):
• Hyperemesis-gravidarum.pdf
• NauseaAndVomitingInPregnancy_2024.pdf

• List of obstetric physicians: Obstetric Physicians - Society of Obstetric Medicine Australian and NZ

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