Hyperemesis gravidarum

Hyperemesis gravidarum is a poorly understood disorder and one for which many physicians have little sympathy, perhaps because we find it difficult to understand its pathogenesis and to treat. It may be associated with dysfunction in a variety of organs, including the thyroid and liver. Many theories, prominently including psychological or behavioral abnormalities, have been proposed to explicate this syndrome. On examination, however, no single theory seems to provide an adequate explanation for hyperemesis gravidarum. Treatment for hyperemesis gravidarum includes fluid and electrolyte supplementation, nutritional support, and total parenteral nutrition, as well as psychological and behavioral therapies and, in selected cases, pharmacotherapy.