<prompt> Differential diagnosis of Hyperemesis gravidarum:GastritisU.T.IReflux oesophagitisAll  <response>: Ans. is a, b and c Nausea and vomiting of pregnancy commonly termed morning sickness is a normal phenomenon in pregnancy, occurring in about 70 of all pregnancies. in most women, it is limited to the first trimester. but a few may continue to have symptoms throughout pregnancy. Hyperernesis gravidarum is the other end of the spectrum characterised by severe nausea and intractable vomiting sufficient to interfere with nutrition. Risk Factors : - Maternal age 35 years High body weight. Nulliparity H. mole - Cigarette smoking Twin pregnancy - Fetal loss Positive family history - Unplanned pregnancy Clinical features are due to : -- Dehydration Stareation Ketoacidosis Vomiting associated with Pregnancy unr-lated to pregnancy Medical W intestinal infestation Urinary tract infection HepatitisPancreatitis Keto-acidosis of diabetes Uraemia CNS disorder Surgical Appendicitis Peptic ulcer reflux Intestinal obstruction CholecystitisCholelithiasis Gynaecological Twisted ovarian tumour Red degeneration of fibroid Management : Mild to moderate Nausea and Vomiting of Pregnancy - usually needs no treatment except reassurance and frequent small meals. Vitamin B5 alone or with doxylamine is safe and can be considered. Vomiting associated with Pregnancy unr-lated to pregnancy Medical W intestinal infestation Urinary tract infection HepatitisPancreatitis Keto-acidosis of diabetes Uraemia CNS disorder Surgical Appendicitis Peptic ulcer reflux Intestinal obstruction CholecystitisCholelithiasis Gynaecological Twisted ovarian tumour Red degeneration of fibroid 