5% dextrose with 0.9% saline versus 0.9% saline solution for the Initial Rehydration of Hyperemesis Gravidarum: A Randomized Controlled Trial

Abstract

Hyperemesis gravidarum (HG) is a debilitating illness affecting 0.3–2.0% of pregnant women. It is characterized by continuous vomiting, dehydration, ketosis and muscle wasting HG is considered one of the most common indications for hospitalization in women with successful pregnancies. Patients affected by hyperemesis gravidarum are dehydrated and starved with associated metabolic, electrolyte, and endocrine disturbances. Hyponatremia is present in 43–49% and hypochloremia in 33–40% on hospital admission. Ketonemia and resultant ketonuria is the consequence of the switch to an alternative energy source when dietary glucose is insufficient for metabolic needs. The brain in the satiated state uses glucose as the exclusive energy substrate.

Correction of dehydration with intravenous fluid is one of the key aims of management. The volume of fluid should be adequate to replenish the deficit and continuing loss through vomiting as well as to meet normal fluid and electrolyte requirements.

Our study compared 44 women with hyperem