Key learning points
- Ensure there is a focus on the patients subjective symptoms and experience Objective measurements such as weight loss values can be useful but dont fully assess the quality-of-life impact that this condition can have.
- Ketonuria is no longer used as an assessment tool in NVP and HG
- The PUQE score can help stratify the severity of symptoms, and guide management
- There are a wide range of antiemetic choices that can be used in a stepwise manner. A combination approach is often needed
- The absolute risk of teratogenic effects of anti-emetics such as Ondansetron are very low. The risk of harm from untreated NVP and HG far outweighs the risk of teratogenicity
- Patients can suffer with severe mental health consequences from NVP and HG. It is important to assess their mental health and provide onward support as needed.