TY - JOUR
AR - SCR-2019-6-105
TI - Surgical Management of Underlying Biliary Disease in Refractory Hyperemesis Gravidarum
AU - Carolyn , Chatterton
AU - Firas , Bridges
AU - Jennifer, McEachron
AU - Pankaj, Singhal
JO - Surgical Case Reports
PY - 2019
DA - Mon 25, Nov 2019
SN - 2613-5965
DO - http://dx.doi.org/10.31487/j.SCR.2019.06.05
UR - https://www.sciencerepository.org/surgical-management-of-underlying-biliary-disease-in-refractory-hyperemesis-gravidarum_SCR-2019-6-105 
KW - Biliary Disease, Hyperemesis gravidarum (HEG), cholecystectomy
AB - Hyperemesis gravidarum (HEG) is the most common cause of hospitalization during the first half of pregnancy. It affects approximately 0.3-3% of all pregnancies [1]. There is no one accepted definition or diagnostic criteria for HEG. The most commonly cited criteria include persistent vomiting not related to other causes, measure of acute starvation (most commonly ketonuria), and weight loss; most often loss of at least 5% of pre-pregnancy body weight [2]. Symptoms typically begin in the late first trimester and are rarely associated with abdominal pain. HEG is managed a stepwise fashion by adding pharmacotherapy sequentially until symptom resolution [3, 4]. Patients who present with classic signs and symptoms of HEG but are non-responsive to all levels of therapy present a therapeutic challenge. In these cases, the search for other causes of nausea and vomiting should be undertaken.