An Unusual Cause of Nausea and Vomiting in Pregnancy

      PA Aline Snietka: Today's case is a 24-year-old G4P2012 female at 9 weeks gestation who presented to our emergency department (ED) complaining of persistent, gradually worsening nausea with non-bloody, non-bilious vomiting over the course of 2 weeks. The patient had been evaluated in the ED several times for her symptoms during this pregnancy, with a history of hyperemesis gravidarum during previous pregnancies. She endorsed vomiting more than five times per day and that she was unable to tolerate any oral solids or liquids. Review of systems was notable for anxiety and myalgias. She denied fevers, chills, headache, abdominal pain, pelvic pain, vaginal bleeding, vaginal discharge, dysuria, urinary urgency or frequency, or flank pain. There were no reported sick contacts or recent travel. Her obstetrical history included two prior cesarean sections and one therapeutic abortion with a dilatation and evacuation procedure. She presented because she could not tolerate oral fluids and was concerned about dehydration.


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