Complications in Early Pregnancy

Emerg Med Clin North Am. 2019 May;37(2):219-237. doi: 10.1016/j.emc.2019.01.004.

Abstract

Early in pregnancy women frequently experience nausea, vomiting, and vaginal bleeding. Nausea and vomiting can be mild, managed by dietary modifications and medications, or severe, requiring intravenous fluids and medications. Care should be used when selecting medications for nausea to avoid additional side effects or potential harm to the developing fetus. When evaluating vaginal bleeding in early pregnancy, ectopic pregnancy must be ruled out. If an intrauterine pregnancy is seen, threatened miscarriage should be considered and the patient appropriately counseled. If neither intrauterine pregnancy nor ectopic pregnancy can be established, a management algorithm for pregnancy of unknown location is presented.

Keywords: Ectopic pregnancy; Hyperemesis gravidarum; Nausea and vomiting in pregnancy; Pregnancy of unknown location; Spontaneous miscarriage; Threatened miscarriage.

Publication types

  • Review

MeSH terms

  • Abortion, Spontaneous / diagnosis
  • Abortion, Spontaneous / therapy
  • Emergency Service, Hospital
  • Female
  • Humans
  • Morning Sickness / diagnosis
  • Morning Sickness / therapy
  • Pregnancy
  • Pregnancy Complications / diagnosis*
  • Pregnancy Complications / therapy
  • Pregnancy Trimester, First*
  • Pregnancy, Ectopic / diagnosis
  • Pregnancy, Ectopic / therapy
  • Uterine Hemorrhage / complications
  • Uterine Hemorrhage / diagnosis