21 y.o G1P0 abd. pain

[suzy2364]

My daughter is a 21 year old G1P0 (9wks, 5 days) with hyper-emesis gravidarum X 2wks; vomiting 10+ X per day.She has been anorexic for 2 weeks.. She was recently hospitalized for two days to rehydrate and stabilize. She was diagnosed during her hospitalization with a UTI (Gram negative 10k+). She was infused antibiotics X1 dose and 6 litres of fluids. In hospital care included Protonix, Zofran, Phenergan and Ativan. Her CBC,CH12, Amy, Lip were normal. She has Behcet's Disease and has been in remission for 3 months.Her flare ups include oral ulcers, fatigue, joint pain and malais. Upon release from hospital, she was improving with continuing milder abd. pain events and infrequent emesis. Post release she began oral meds, including all in hospital drugs with the exception of Ativan. This drug was replaced with Ambien. She also was prescribed Macrobid for the UTI. Macrobid doses are immediately followed by emesis for 3-4 hours with increased level of abd. pain. ( upper mid quadrant). I am concerned that the abdominal pain may be due to medication related exaserbation of irritated upper GI tract, and may result in vasculitic changes in her upper GI tract resulting in Behcets sx due to stress. What can we do to diagnose, treat and manage this during the course of the pregnancy? She has been unable to work for 2 weeks and must return soon. She is allergic to PCN, EES, Sulfa and Vicodin. She smokes 1-2 cigarettes daily and is planning to stop within a week. She does not drink alcohol. Her previous meds include Prozac, Colchisine, Albuterol and occassional Ibuprofen. All dc'd except Albuterol. ( additionally, the pregancy resulted from a date rape drug event)

Suzy

[prayerful wife]

She's on a lot of meds...I know the macorbid alone is enough to make you sick, and depending on the dosage of the Ambien it leaves you feeling pretty yucky if you dont get the adequate amount of rest.  My heart just goes out to her and to you for having to go through this with her.  I know with the frequent vomiting she's so dehydrated and cant be properly nourishing herself.  Is there maybe a specialist the OB can refer her to?  You are definitely in my prayers.  Please keep us updated.

[amberd5191]

I would take her back into a OB doctor and have them see how bad her vomiting is, they may start home IV treatments to make sure that all goes well.