Hyperemesis Gravidarum PICC line

Specialties Ob/Gyn

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Specializes in L&D, NICU, PICU, School, Home care.

Pt with horrible hyperemesis still at 31 weeks. Lytes (esp potasium) abnormal. IV sites are non existent so PICC line placed. She did better when able to get meds before emesis gets worse.

We were getting conflicting info from other docs that frightened the pt who had PICC removed. Now we are back to trying to find IV sites every few days.

Opinions on the PICC lines and/or treatments that will help her get to term with a healthy baby.

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Specializes in NICU, PICU, PACU.

What did the doc say to her? I work at a high risk center and we have moms with PICCs without a problem. They even go home with them sometimes.

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Specializes in Complex pedi to LTC/SA & now a manager.

I don't work in that area but know someone who instead of picc went with continuous sub q infusion of Zofran with better results than IV. Since the Zofran subq worked she was able to rehydrate with PO fluids

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Specializes in L&D, NICU, PICU, School, Home care.

The doc told her they would cause clots that could she or the baby could die. She was home with the PICC still needed to come to hospital but much less frequently.

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Specializes in L&D, NICU, PICU, School, Home care.

Do you know if they ever do subq raglan. It seems to work better for her.

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Specializes in Complex pedi to LTC/SA & now a manager.

Here's a journal article:

Home subcutaneous metoclopramide therapy for hyperemesis gravidarum

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Specializes in Complex pedi to LTC/SA & now a manager.

Know that just because IV or ODT Zofran doesn't work, it may be highly effective continuous subq. My anecdotal experience the mom compared it to catching up to pain control. If you keep ahead of the pain, lower doses are more effective. She was reluctant to try subq Zofran because it was not effective IV or ODT when already nauseous, but it allowed her to go home in bed rest (until early labor started necessitating inpatient monitoring)

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I lived through a situation you are describing and it's why I want to get into the nursing field :)

I had a PICC line placed in the first trimester and kept it my entire pregnancy (with a zofran pump 1mg/hr, and 1L of ringers daily). I had the PICC removed the day I was discharged home with my baby. I ran into professionals that weren't fans of me keeping the PICC but my OB was comfortable with it in long term so that's what ended up happening. I was also on diclegis, nexium and phenergan (sp?). Personally, I thought the order for a PICC was the best thing that happened to me. I wish I could offer a perfesional answer to your post but I hope to one day when I'm a nurse!

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