Hyperemesis gravidarum (HG) is defined as a severe form of Nausea and Vomiting of Pregnancy (NVP) and is characterized by nausea and excessive vomiting that can start as early as the 6th week of pregnancy, and last up to the middle of the second trimester. No definitive diagnostic criteria exist that could exactly differentiate HG from NVP, but in clinical practice loss of >5% of body mass as a result of vomiting and loss of appetite is considered a clear sign of the disorder. Pregnant women with HG can also have other gastrointestinal, metabolic and neurological symptoms, so it is important to rule out other possible causes of vomiting in pregnancy. Since the disorder is self-limiting, the primary aim of the treatment is to manage the symptoms and avoid possible complications due to hypovolemia and malnutrition. The therapeutic approach can be nonpharmacological in milder cases, but in severe cases, vitamin B6 (pyridoxine) in combination with doxylamine has proven to be the most effective therapy.
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