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Nutrition in Clinical Practice
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Invited Review: Nutritional Management of Hyperemesis Gravidarum

Beth A. Wagner, RN, MSN, CNSN

Department of Home Infusion Service, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania

Patricia Worthington, RN, MSN, CNSN

Department of Nursing, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania

Karen E. Russo-Stieglitz, MD

Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania

Amy B. Levine, MD

Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania

Vincent T. Armenti, MD, PhD

Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania

Hyperemesis gravidarum (HG) was once a major cause of maternal mortality. The impact of prolonged and severe nausea and vomiting on the fetus and mother can be devastating. Disturbances in fluid, electrolyte, and acid-base balances are common. The reduction in maternal deaths associated with HG is a result of improved understanding and more aggressive treatment of these metabolic alterations. HG is the most common reason for nutrition support intervention during pregnancy. However, little information is available regarding the nutritional issues associated with HG or the effects of providing nutrition support on pregnancy outcome. This review discusses the nutritional implications of HG and strategies for clinical management, including hydration, pharmacologic therapies, and the provision of enteral and parenteral nutrition. Implications for home care and future research are also presented.

Nutrition in Clinical Practice, Vol. 15, No. 2, 65-76 (2000)
DOI: 10.1177/088453360001500203
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