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1. Examination includes the following:
2. Laboratory tests
3. The following imaging studies may be used to assess women with hyperemesis gravidarum:

Obstetric ultrasonography: Usually warranted to evaluate for multiple gestations or trophoblastic disease

Volume status (eg, mucous membrane condition, skin turgor, neck veins, mental status)

Hepatitis panel

Hematocrit level

Serum levels of electrolytes and ketones

Cardiac evaluation

Thyroid stimulating hormone, free thyroxine levels

Abdominal computed tomography scanning or magnetic resonance imaging: If appendicitis is suspected as a cause of nausea and vomiting in pregnancy

Abdominal evaluation

Thyroid evaluation

Calcium level

Urine culture

Amylase/lipase levels

Urinalysis for ketones and specific gravity

Vital signs, including standing and lying blood pressure and pulse

Neurologic evaluation

Liver enzymes and bilirubin levels

General appearance (eg, nutrition, weight)

Upper abdominal ultrasonography: If clinically indicated, to evaluate the pancreas and/or biliary tree