Obstetrics & Gynaecology
Hyperemesis Gravidarum
RCOG Green-top 69 — PUQE score, exclude alternatives, IV fluids + thiamine + antiemetics, admission criteria.
Source: RCOG Green-top 69 (2016)
Step 1 of ~4
info
Definition + Severity
Hyperemesis gravidarum: persistent N+V in pregnancy + dehydration + ≥5% pre-pregnancy weight loss + electrolyte imbalance. Onset typically 4–7 weeks; peak 9 weeks; usually resolves by 20 weeks. Use Pregnancy-Unique Quantification of Emesis (PUQE) score: <6 mild; 7–12 moderate; ≥13 severe. Verify all paediatric drug doses against BNFc if applicable (relevant for pregnant adolescents).
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Ondansetron (Hyperemesis Gravidarum) · 5-HT3 Receptor Antagonist (Antiemetic — Hyperemesis Gravidarum)
- Cyclizine (Nausea and Vomiting in Pregnancy) · Antihistamine Antiemetic — Hyperemesis Gravidarum
- Prochlorperazine (Nausea and Vomiting in Pregnancy) · Phenothiazine Antiemetic — Hyperemesis Gravidarum
- Camellia sinensis (sinecatechins) · Topical green tea catechin extract
- Thiamine (IV/IM — Pabrinex) · Vitamin B1 (Thiamine) — deficiency treatment / Wernicke's encephalopathy prevention
- Thiamine (Vitamin B1) · Vitamin B1 Supplement
Pathways
- Spinal Anaesthesia Hypotension Management · AAGBI; ASA
- Pre-Eclampsia / Eclampsia in ED · NICE NG133; RCOG Green-top 10A
- Suspected Ectopic Pregnancy · NICE NG126; RCOG Green-top 21
- Polycystic Ovary Syndrome (PCOS) · International PCOS Guideline 2023; NICE CKS
- Pre-eclampsia Management · NICE NG133 2019
- Ectopic Pregnancy · NICE CG154 / RCOG GTG 21
Decision support only. Always apply local guidelines and clinical judgement.