Abstract
Hyperemesis Gravidarum (HG) is a condition at the extreme end of the pregnancy sickness spectrum, which can cause poor oral intake, malnutrition, dehydration and weight loss. The aim of this study is to explore the role of Registered Dietitians (RD) in the management of HG in the United Kingdom (UK). A survey was designed and distributed electronically to members of the British Dietetic Association. There were 45 respondents, 76% (n = 34) worked in secondary care hospitals, 11% (n = 5) were in maternal health specialist roles. The most commonly used referral criteria was the Malnutrition Universal Screening Tool (40%, n = 18), followed by second admission (36%, n = 16). However 36% (n = 16) reported no specific referral criteria. About 87% (n = 37) of respondents did not have specific clinical guidelines to follow. Oral nutrition supplements were used by 73% (n = 33) either ‘sometimes’ or ‘most of the time’. Enteral and parenteral nutrition were less commonly used. There was an inconsistent use of referral criteria to dietetic services and a lack of specific clinical guidelines and patient resources. Further training for all clinicians and earlier recognition of malnutrition, alongside investment in the role of dietitians were recommended to improve the nutritional care of those with HG.
Highlights
Accepted: 3 June 2021Nausea and vomiting are reported to be experienced by around 70% of pregnant women [1]
The aim of this study is to explore the role of dietetic practice in the management of pregnancies affected by Hyperemesis Gravidarum (HG) in the United Kingdom (UK), with a focus on referral criteria, clinical management and strategies to improve nutritional outcomes
Total of 45 participants completed the survey, of which the majority worked in a secondary care hospitals in England
Summary
Nausea and vomiting are reported to be experienced by around 70% of pregnant women [1]. It is estimated to affect 1.5% of pregnant women in the United Kingdom (UK) [2], with rates of 0.8–3.3% reported in other populations [3,4,5,6]. There is no agreed definition of HG, which makes diagnosis, management and research challenging; but HG is typically reported as involving persistent and intractable nausea and vomiting with the triad of more than 5% pre-pregnancy weight loss, dehydration and electrolyte imbalance [7]. Symptoms of HG can be persistent, resulting in prolonged poor oral intake, malnutrition, dehydration and weight loss [9,10,11]
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