my wife has hyperemesis and we are expecting a baby i have given doxylamine and pyridoxine with emeset tablet still the vomiting is not controlled
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"hyperemesis gravidarum" AND treatment
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ACOG nausea vomiting pregnancy hyperemesis gravidarum when hospitalize IV fluids thiamine guideline
She needs same-day assessment by her obstetrician or an emergency department, especially since vomiting is continuing despite doxylamine-pyridoxine and Emeset (ondansetron). Hyperemesis can quickly cause dehydration, low potassium or other electrolyte problems, and weight loss. Severe, antiemetic-unresponsive vomiting is a common reason for hospital treatment in pregnancy.
Go to emergency care now if she has any of these:
- Cannot keep down fluids or her medicines
- Very little urine, dark urine, or no urination
- Dizziness, fainting, fast heartbeat, confusion, or severe weakness
- Vomiting blood, severe abdominal pain, fever, severe headache, or vaginal bleeding
- Noticeable weight loss
Do not keep adding or increasing medicines on your own. Doxylamine-pyridoxine and ondansetron can be appropriate options in pregnancy, but the right dose, timing, interactions, and next medicine must be decided by her obstetric clinician. She may need:
- IV fluids and blood tests for electrolytes and kidney/liver function
- Vitamins, particularly thiamine (vitamin B1) if prolonged vomiting or IV dextrose is being considered
- A clinician-selected additional or alternative anti-vomiting medicine
- Treatment for reflux or stomach irritation if contributing
- Admission if she remains unable to drink, is dehydrated, or is losing weight
Until she is seen, offer very small, frequent sips of oral rehydration solution, water, or ice chips only if she can tolerate them. Do not force food or large volumes at once.
ACOG advises that people with hyperemesis may need hospital care, IV fluids/vitamins, testing, and additional medication when vomiting cannot be controlled. ACOG patient guidance
A recent systematic review of treatments is indexed as PMID 37891710.
A recent systematic review of treatments is indexed as PMID 37891710.
Upt is negative and her menstrual due date is monday only
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pregnancy test false negative urine hCG
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NHS pregnancy test negative before missed period repeat test if period late vomiting dehydration urgent medical advice
If her period is only due on Monday, a negative urine pregnancy test does not reliably rule out a very early pregnancy. It may simply be too early for hCG to be detectable, especially if the urine was dilute. Home tests are most reliable from the first day of a missed period. NHS guidance
What to do:
- Do not assume this is hyperemesis gravidarum yet. That diagnosis requires pregnancy plus severe persistent vomiting.
- Repeat a urine pregnancy test using first-morning urine on Monday or 48 hours later if no period comes. If still negative and the period does not start, get a blood beta-hCG test through a doctor.
- Until pregnancy is clarified, do not give more doses or additional anti-vomiting tablets without a clinician or pharmacist advising you, particularly because medication safety and dosing depend on the cause and whether she may be pregnant.
- Persistent vomiting can also be due to gastroenteritis, food poisoning, gastritis/reflux, migraine, urinary infection, medication effects, or less commonly an abdominal problem. She should be assessed today if it is not settling.
Take her for urgent assessment now if she cannot keep fluids down, has dark/scant urine, dizziness or fainting, severe weakness, fever, strong or one-sided lower abdominal pain, blood in vomit, vaginal bleeding, or shoulder-tip pain. These symptoms need prompt evaluation even before a pregnancy test turns positive.
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