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Natural Birth & Parenting Natural Birth & Parenting

Ordering an Emergency Ultrasound

Posted by on Apr. 7, 2011 at 4:16 PM
  • 9 Replies

for dehydration?

My cousin is about 8 weeks pregnant and has hyperemesis.  Okay, yeah, that sucks.  I know all about it.  She was admitted to the ER and put on IV fluids for 5-6 hours because she had been sick for about 12 hours and has been sick in general and losing weight.  Her doctor ordered an emergency ultrasound because she was dehydrated.  Really?  

Back in 2006 when I was pregnant, I had hyperemesis (had lost about 20 pounds) and an infection (didn't know there was an infection too).  I had been sick for hours -couldn't keep anything down.  I was admitted for observation and put on IV fluids for dehydration.  Stuff started coming out everywhere (which is when my doctor realized I had a gastrointestinal infection too), and I was there for 3 days.  He wasn't worried that the baby was in jeopardy because I wasn't cramping or bleeding.

What's with the ultrasound?  I mean, what could being dehydrated for half a day do to a fetus, and what exactly are they going to see on an 8-week ultrasound?  If they would find something "wrong", what would they do about it?


CafeMom Tickers
by on Apr. 7, 2011 at 4:16 PM
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Replies (1-9):
Pandapanda
by on Apr. 7, 2011 at 4:46 PM

BACKGROUND: Traditionally, in cases of hyperemesis gravidarum (HG), an ultrasound evaluation is recommended to confirm viability and to exclude multiple pregnancies and gestational trophoblastic disease (GTD). Our aim was to perform a case–control study to evaluate the incidence of these findings. METHODS: Each case of HG was matched for gestational age with the next ultrasound examination performed in an asymptomatic pregnancy. The findings were compared between the two groups. RESULTS: Two hundred and eighty-six cases of HG were matched with 286 asymptomatic women. The total number of viable pregnancies was higher in the HG group (280/286, 97.9%) than that in the control group (265/286, 92.6%; P = 0.006). The incidence of twins was 3.1% in each group (P > 0.999). The incidence of early pregnancy failure was 0.7% in women with HG compared to 7.0% in asymptomatic women (odds ratio 0.09, 95% CI 0.01–0.04, P < 0.0001). The one case of GTD was in the HG group; however, this case also presented with vaginal bleeding. CONCLUSIONS: Pregnancies complicated by HG had a similar risk of twin pregnancy, and a lower risk of early pregnancy failure compared to controls. In the absence of vaginal bleeding, there was no increase in GTD in women with HG. We conclude that an ultrasound scan is not clinically necessary in women presenting with HG, other than for maternal reassurance.

doulala
by Gold Member on Apr. 7, 2011 at 5:16 PM

Trying to get the AFI number maybe?


truealaskanmom
by on Apr. 7, 2011 at 7:19 PM

I think part of it is that hyeremsis can be linked to molar pregnancies as well.

Roadfamily6now
by on Apr. 7, 2011 at 8:23 PM

I'd want one just to make sure baby was okay. I have never had hypermsis but if I did, I'd be paranoid. :) Sorry, just my personal 2cents. I don't fault any OB for a quick check in a case like that.

rachelrothchild
by Silver Member on Apr. 7, 2011 at 9:53 PM

Interesting answers, everyone.  Thanks.

skittles2011
by on Apr. 8, 2011 at 7:02 PM

 kinda makes me wonder why they didnt want to check my baby when i was 14 wks pregnant and went to the er with dehydration. i couldnt keep food down for 24 hrs and couldnt keep liquids down for 12 and all i got was fluids and they told me to check with ob the next day. but when i did all they said was we'll put that in your chart that you went to the er.

MyIslandGirls
by Bronze Member on Apr. 9, 2011 at 8:09 PM

I went to the ER with my last pregnancy at 19 weeks because i was throwing up for 3 days straight and couldn't geep anything do either. I was also given fluids for 4 hours (4 iv bags full) and was never sent for an altrasound. Fetal heart rate was checked and baby was fine.. a little high but he was active at the time so that made sense.

Maybe it's more about her gestational age?

partera813
by on Apr. 9, 2011 at 9:12 PM
Because fetal demise and infection of the waters can cause hyperemis as well. In addition, multiple gestation can increase hormone levels and subsequently increase nausea and vomitting.
rachelrothchild
by Silver Member on Apr. 10, 2011 at 9:04 AM

She had exactly the same thing her first pregnancy, and she has a perfectly healthy 1 year old.  No multiples.

Quoting partera813:

Because fetal demise and infection of the waters can cause hyperemis as well. In addition, multiple gestation can increase hormone levels and subsequently increase nausea and vomitting.


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