An Unusual Case of Nausea and Vomiting in Pregnancy: A Case Report

Babu Karavadra*, Medha Sule and Christine-Antoinette Portelli

An Unusual Case of Nausea and Vomiting in Pregnancy: A Case Report

Nausea and vomiting in pregnancy are common. The most
common diagnosis associated with such symptoms is hyperemesis gravidarum.

However, it is important to be very mindful about other important,
and life-threatening conditions that may also mimic hyperemesis gravidarum.

We describe an unusual case of nausea and vomiting in pregnancy in this case report.
A 30-year-old woman in her first pregnancy presented at 19-weeks
gestation to the acute gynaecology ward with worsening nausea
and vomiting since the first trimester.

She had been prescribed a multitude of different antiemetics throughout her pregnancy, but
with limited effect. During her admission, she vomited 1200 ml
of bilious fluid.

She also had a positive urinalysis with leucocytes, nitrites and ketones;
treatment for a urinary tract infection (UTI) was commenced with a cephalosporin.

The same day, on auscultation of her tender abdomen she was found to have sluggish bowel.
An ultrasound abdomen showed a gravid uterus but a
markedly distended stomach containing fluid and food debris.

It also showed multiple distended fluid filled ileal loops in the upper
abdomen. The liver, spleen, pancreas and both kidneys all appeared

normal. There was no biliary dilatation nor gallstones.

There was a small amount of free fluid in the pelvis. The ultrasound conclusions were in keeping with a degree of gastroparesis/small-bowel ileus. Following this a nasogastric tube was inserted.

She had a long-standing history of more than six months
gastric reflux and difficulty in eating with bloated symptoms; she
had been treated by her general practitioner (GP) and omeprazole.

Gynecol Obstet Res Open J. 2020; 7(1): 1-3. doi: 10.17140/GOROJ-7-152