Early pregnancy reaction

Introduction Early pregnancy response means early pregnancy (about six weeks after menopause), increased chorionic gonadotropin (HCG) in pregnant women, decreased gastric acid secretion and prolonged gastric emptying, leading to dizziness, fatigue, loss of appetite, acid food or disgusting greasy A series of reactions such as nausea and morning vomiting. Hyperemesis of pregnancy is persistent nausea and vomiting, leading to acidosis and imbalance of electrolyte balance, or abnormal liver function requiring hospitalization to control metabolic disorders.

Cause

The etiology of hyperemesis in pregnancy has not been known so far, which may be mainly related to the imbalance of hormonal mechanism and mental state in the body. The role of hormones refers to the highest level of HCG in the first trimester of pregnancy when the vomiting of pregnancy is the most serious; the HCG concentration in the blood of patients with twin pregnancy or blister block is significantly increased, and the occurrence of hyperactivity is also significantly increased, suggesting that the disease Close relationship with HCG.

In addition, if the adrenal cortical function is low, the secretion of corticosteroids is insufficient, so that the water and carbohydrate metabolism in the body is disordered, gastrointestinal symptoms such as nausea and vomiting appear, and the symptoms can be significantly improved when ACTH or corticosteroid treatment is used, so the adrenal function is also considered. Lowering also has a certain relationship with pregnancy vomiting. It is believed that vitamin B6 deficiency may also be one of the causes of the disease.

In any case, the mental factors have a great relationship with the occurrence of hyperemesis in pregnancy, especially pregnant women have fear of pregnancy, or bored, and influenced by folk feudal superstitions, etc. can cause vomiting. There is a history of severe dysmenorrhea, an increase in pregnancy vomiting.

an examination

Related inspection

Urine pregnancy test (HCG) blood electrolyte test

According to the medical history and clinical manifestations, it is first clear whether pregnancy, if it is definitely a pregnancy, it is also necessary to exclude vomiting caused by the digestive system or other diseases of the nervous system. After the diagnosis of pregnancy vomiting, it is necessary to determine the severity according to clinical manifestations. For severe cases, the following tests are required:

First, blood

Check the blood routine and hematocrit to help understand the presence or absence of blood concentration. If possible, the whole blood viscosity and plasma viscosity can be checked. Carbon dioxide binding or blood gas analysis to understand blood pH, alkali storage and acid and acid balance. Also need to measure serum bilirubin, liver and kidney function.

Second, urine

Urine volume was calculated daily, urine specific gravity, ketone body, and urine tricholesterol test.

Third, ECG examination

This test is particularly important and can be used to help detect the presence or absence of hypokalemia or hyperkalemia and myocardium.

Differential diagnosis

The symptoms of early pregnancy response need to be differentiated from the following symptoms.

First, morning sickness

For the most common condition in early pregnancy, nausea and salivation or mild vomiting may occur in the early morning, but it does not affect daily life.

Second, moderate hyperemesis (moderate hyperemesis)

It is aggravated by nausea and vomiting, and is not limited to the morning, but the symptoms can be alleviated by symptomatic treatment and dietary guidance such as eating a fluid or semi-liquid and low-fat diet.

Third, vicious vomiting (pernicious vomiting)

In order to continue nausea and vomiting, resulting in acidosis and electrolyte imbalance, or abnormal liver function, hospitalization is needed to control metabolic disorders. Only this type of incidence is not high, about 1:250 ~ 1:350 need hospitalization.

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