19th April 2022

A 29-year-old primiparous woman, who is 25 weeks pregnant, presents to A+E

A 29-year-old primiparous woman, who is 25 weeks pregnant, presents to A+E with vomiting and diarrhoea. Her partner brought her, saying she began acting out of character this morning, complained of feeling unwell, and has been vomiting with diarrhoea since. She has a history of hyperthyroidism, which has been well-controlled with carbimazole under specialist review. Her pregnancy has been uneventful, aside from a mild upper respiratory tract infection last week.

Her observations are as follow:

Airway patent, respiration rate difficult to assess due to vomiting, O2 sats 94%, heart rate 150bpm, blood pressure 154/108. Temperature 38.6°C She is drowsy and confused but responds to voice.

Given this presentation, what is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.