Hyperemesis

gravidarum
Definition & Causes

Definition : extreme, persistent nausea and vomiting

during pregnancy. It can lead to dehydration, weight
loss, and electrolyte imbalances

Causes : unknown and various mechanisms have been

proposed including an association with high levels of
serum human chorionic gonadotrophin (hCG),
oestrogen and thyroxine
Risk Factors ..
o Multiple pregnancies.
o Women experiencing their first
pregnancy.
o Underweight and obesity.
o Young woman.
o Psycho-social factors such as unwanted.
o Pregnancy , marital problem……etc..
o Having a history of HG.
o Being pregnant with more than one baby.
o Being a first-time mother.
Signs & symptom..
Signs Symptoms

•Dehydration • Excess vomiting & retching day

•Muscle wasting & night.
•Ketosis • Vomiting initially watery &
•Weight loss > 5% of pregnancy weight bilious.(Weight loss seen)
•Tachycardia • Oliguria
•Postural hypotension • Seldom mental symptoms
•Dry coated tongue • Epigastric pain
•Sunken eyes • Constipation
•Acetone smell in breath • Spitting
• Fatigue
• Anorexia
Complication

Maternal Fetus

• Weight loss  Intrauterine growth

• Dehydration
• Acidosis
• Hyponatremia
• Hypokalemia
• Vitamin deficiency
• Mallory Weiss
• wernicke’s encephalopathy
restriction IUGR
 Fetal anomalies
 If it uncontrolled fetal death
may occur IUFD
 Low birth weight
Management

 Principles of management:-

 To control vomiting : antiemetic drug

 To correct fluid & electrolyte imbalance : iv fluid
 To correct metabolic disturbance : mutlivitamin
Nursing Management

 Monitor urine for ketone.

 Monitor fetal heart rate, fetal activity & fetal
growth.
 Encourage intake of small proportion of food.
 Liquid should be taken b/w meals to avoid
distending stomach & triggering vomit.
 Encourage patient to sit upright after meal.
Thank You
