Effect of excessive vomiting in pregnancy

1. Metabolic changes -
- Inadequate intake of food results in glycogen depletion. For the energy supply, the fat
  reserve is broken down.
- Due to low carbohydrate, there is incomplete oxidation of fat and accumulation of ketone
  bodies in the blood.
- The acetone is ultimately excreted through the kidneys and in the breath.
- There is also increase in endogenous tissue protein metabolism resulting in excessive
  excretion of non-protein nitrogen in the urine.
- Water and electrolyte metabolism are seriously affected leading to biochemical and
  circulatory changes.

2. Biochemical changes - 
- Loss of water and salts in the vomitus resulting in fall in plasma sodium, potassium
  and chlorides.
- The urinary chloride may be well below the normal 5 gm/litre or may even be absent.
- Hepatic dysfunction results in acidosis and ketosis with rise in blood urea and uric acid ,
  hypoglycaemia, hypoproteinaemia, and hypovitaminosis.

3. Circulatory changes - 
There is haemoconcentration leading to rise in haemoglobin percentage, RBC count and
haematocrit values. There is slight increase in the white cell count with increase in eosinophils.
There is concomitant reduction of extracellular fluid.