Advertisement

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.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Emergency Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • May L
        • Rutter S
        • Whitby EH
        • et al.
        Incarcerated retroverted uterus manually replaced in 24 week pregnancy.
        Obstet Gynecol Cases Rev. 2019; 6: 142
        • Debay A
        • Badeghiesh A
        • Baghlaf O
        • et al.
        Pregnancy, delivery, and neonatal outcomes among women with incarcerated uteri: a population-based study of a large US database.
        Eur J Obstet Gynecol Reprod Biol. 2022; 276: 21-25
        • Han C
        • Wang C
        • Han L
        • et al.
        Incarceration of the gravid uterus: a case report and literature review.
        BMC Pregnancy Childbirth. 2019; 19: 408
        • Lackey A
        • Dara P
        • Burkhardt C.
        Recurrent incarceration of the severely retroverted uterus with successful second-trimester reduction.
        J Obstet Gynaecol. 2019; 39: 549-551
        • Fahimuddin FZ
        • Murphy R
        • O'Shaughnessy M
        Surgical management of an incarcerated uterus in a gynecological patient: a case report.
        Case Rep Womens Health. 2019; 23: e00123
        • Kim YS
        • Kwon BS
        • Lee YJ.
        Clinical approach and management of uterine incarceration according to trimester of pregnancy: case report and literature review.
        Taiwan J Obstet Gynecol. 2021; 60: 911-915
        • Carney AC
        • Tobler KJ.
        First trimester uterine incarceration resolved with conservative management in a multifetal gestation.
        Obstet Gynecol. 2019; 133 (122S–123S)
        • Lawrence A
        • Morelli E
        • Simoni M
        • Illuzzi J.
        Uterine incarceration: a case study.
        J Midwifery Womens Health. 2018; 63: 352-356
        • Gardner CS
        • Jaffe TA
        • Hertzberg BS
        • Javan R
        • Ho LM.
        The incarcerated uterus a review of mri and ultrasound imaging appearances.
        AJR Am J Roentgenol. 2013; 201: 223-229
        • Sweigart AN
        • Matteucci MJ.
        Fever, sacral pain, and pregnancy: an incarcerated uterus.
        West J Emerg Med. 2008; 9: 232-234
        • Camille AC.
        Urinary retention in the case of a retroverted uterus in pregnancy.
        Obstet Gynecol Cases Rev. 2020; 7: 163
        • DeYoung TH
        • Fluke LM
        • Greer JA.
        Uterine incarceration during pregnancy.
        in: Nezhat CH Kavic MS Lanzafame RJ Lindsay MK Polk TM Non-obstetric surgery during pregnancy: a comprehensive guide. Springer International Publishing, New York2019: 371-380
        • Peng Y
        • Zeng S
        • Luo Y.
        Diagnosis and treatment for incarceration of retroverted uterus during pregnancy: a report of four cases.
        Chin J Perinat Med. 2021; : 141-146