28 yr female concieved 5 years after marriage now she is 3 months anc c o sever vomiting( 7 -8 eposodes ) despite she is taking doxinate od hs cap omez 20 tab emeset od in morning tsh done value is 0.07 pls opine about further management and treatment



This may be a case of hyperthyroidism induced hyper emesis Put the pt on PTU 50 mg TDS Also add oral methylprednisolone 8mg BD for 15 days than taper gradually

Oral tab of omnacortil 5mg bd for 7 to 10 days intermittently Iv fluid with injection polybion and when symptoms subsides than again continue with doxinate. Pantoprazole can be given intermittently.

Hyperthyroidism.. go for T3T4Tsh..n take endocrinologist consultation

For hyperthyroid please repeat thyroid profile. If hyperthyroid is confirmed , consult endocrinologist. Inj Ondensetron -1amp is sufficient for 24-48hrs, depending upon patient. Please do USG pregnancy, LFT,and other antenatal investigation

tab ondem MD in morning doxinate plus in morning one tab 2:HS .high glucose diet orally to avoid hypo gly due to excessive vomiting.i/v can b given.

Tab and inj ondensetraniamp 6hrly and iv fluids can settle the pt. Pl RptT3T4 TSH

T Pregnidoxin od, iv fluids with inj energect, vomiset, pantop

Sir..Cross check her hyperthyroidism with another report of free t3 free t4 n free tsh..and for hyperemesis tab granisetron can be added ..twice daily

Take LFT And phenergan

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