HYPEREMESIS GRAVIDARUM IN ENGLISH

                                               

                          HYPEREMESIS GRAVIDARUM IN ENGLISH

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HYPEREMESIS  GRAVIDARUM –

Nausea and vomiting are common symptoms of pregnancy, affecting approximately 70% of women with the onset from 4–8 weeks’ gestation and lasting until 16–20 weeks

Hyperemesis gravidarum is the severest form of nausea and vomiting and occurs in 3.5 per 1000 pregnancies. The woman presents with a history of vomiting that has led to weight loss and dehydration.

Hyperemesis gravidarum is defined as-

“Excessive vomiting during pregnancy leading to dehydration, electrolyte imbalance, ketosis, and weight loss of more than 5% of pre-pregnancy weight.”

Causes (multifactorial):

- Increased HCG levels

- Increased Estrogen and progesterone levels

- Psychological factors (stress, anxiety)

- Helicobacter pylori infection

Risk factors:

- First pregnancy

- Multiple gestation

- Molar pregnancy

- History of HG in previous pregnancy

- Obesity

Clinical manifestations –

- Severe, persistent vomiting

- Inability to tolerate food & fluids

- Weight loss (>5% pre-pregnancy weight)

- Signs of dehydration: dry mouth, low BP, tachycardia

- Oliguria

- Electrolyte imbalance symptoms: muscle weakness, confusion

- Ketotic breath odor

Diagnostic investigations

- Urinalysis: ketones, specific gravity

- Blood tests: electrolytes, renal function, liver enzymes

- Thyroid function tests

- Ultrasound – exclude molar pregnancy, multiple gestation

Complications    -

If left untreated:

- Severe dehydration → hypovolemic shock

- Electrolyte imbalance → arrhythmias

- Wernicke’s encephalopathy

- Renal failure

- Fetal growth restriction or preterm birth

medical management-

-Antiemetics: such as Ondansetron, Metoclopramide, Promethazine

- Vitamin supplementation (especially thiamine)

Nutritional support (NG feeding / parenteral nutrition)

-Hospitalization if severe with monitoring and

IV fluid replacement (Normal saline ± potassium)

nursing management-

Assessment:

- Monitor vitals, weight, fluid balance, urine output

Check for dehydration & electrolyte imbalance

Interventions:

- Maintain NPO initially, then reintroduce clear fluids

- Provide small, frequent meals once tolerated

- Avoid strong odors and greasy foods

- Emotional support & reassurance

Health Education patient and family to

-Eat small, frequent meals

- Avoid triggers (strong smells, spicy foods)

- Keep hydrated

- Rest and stress reduction

- Early reporting of persistent vomiting