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Hyperemesis Gravidarum

 

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Hyperemesis Gravidarum is a diagnosis of exclusion and may result in weight loss; nutritional deficiencies; and abnormalities in fluids, electrolyte levels, and acid-base balance. According to the Hyperemesis Education and Research Foundation , hyperemesis gravidarum (HG) is described as "unrelenting, excessive pregnancy-related nausea and/or vomiting that prevents adequate intake of food and fluids. Some women may have nausea and vomiting throughout the pregnancy. The cause of morning sickness may be due to the changes in hormone levels during pregnancy. More severe cases often require a stay in the hospital so that the mother can receive fluid and nutrition through an intravenous line (IV). Until vomiting is controlled, these patients should be maintained in a fasting state. A low dose, continuous intravenous infusion of anti-nausea medication, such as Phenergan, can have beneficial effects. Vitamins, including thiamine, can be added to supplement the intravenous fluids. Patients with intractable, prolonged vomiting may be treated with nasal feeding tubes, peripheral or central intravenous nutrition. Rarely is interruption of pregnancy necessary. Permission is hereby granted to print one hard copy of the information on an individual disease for your personal use, provided that such content is in no way modified, and the credit for the source (NORD) copyright notice are included on the printed copy. Any other electronic reproduction or other printed versions is strictly prohibited.

Hyperemesis gravidarum (from the Latin for "extreme vomiting of the pregnant woman") is a severe form of morning sickness. About half of all pregnant women experience nausea and sometimes vomiting in the first trimester - a condition often called morning sickness, as these symptoms are often more severe in the morning. Pyelonephritis, pancreatitis, cholecystitis, hepatitis, appendicitis, gastroenteritis, peptic ulcer disease, thyrotoxicosis, and hyperthyroidism can present insimilar fashions, with intractable nausea and vomiting, and are treatable conditions. The vomiting is typically intractable and leads to evidence of disturbed nutrition, altered electrolyte balance or dehydration. Psychological theories of the etiology are falling out of favor, and the American College of Obstetrics and Gynecology warns that attributing vomiting to psychological disorders has likely impeded progress in understanding the true etiology of hyperemesis gravidarum. The exact number of sufferers is difficult to pinpoint because symptoms of nausea and vomiting during pregnancy exist on a continuum, and there is no clear boundary between common morning sickness and hyperemesis.

Causes of Hyperemesis Gravidarum

The common Causes of Hyperemesis Gravidarum :

  • The cause of severe nausea and vomiting in pregnancy has not been identified. Hyperemesis may have a genetic component, as sisters and daughters of women with hyperemesis have a higher incidence.
  • Cigarette smoking and maternal age older than 30 years appear to be protective.
  • Vomiting blood .
  • Women with history of motion sickness, migraine headaches, psychiatric illness, pregestational diabetes, high or low pregestational weight, hyperthyroidism, pyridoxine deficiency, and gastrointestinal disorders are also at an increased risk.
  • Hyperemesis is also associated with hyperemesis in prior pregnancy, female gestation, multiple gestation, triploidy, trisomy 21, current or prior molar pregnancy, and hydrops fetalis.
  • The Helibacter Pylori infection (which causes stomach ulcers ).
  • Vitamin B deficiency.
  • Rapid weight loss (amounting to at least 5% of pre-pregnancy body weight).

Symptoms of Hyperemesis Gravidarum

Some common Symptoms of Hyperemesis Gravidarum :

  • Symptoms of pregnancy.
  • Vomiting not related to eating.
  • Severe nausea
  • Fainting.
  • Confusion .
  • Dehydration.
  • Persistent excessive vomiting (often leading to weight loss).
  • Lightheadedness or fainting.
  • Weight loss.
  • Jaundice.
  • Vomiting after eating or drinking .
  • Headaches.

Treatment of Hyperemesis Gravidarum

  • Treatment of blood chemical balance.
  • Medication to prevent nausea is reserved for cases where vomiting is persistent and severe enough to present potential maternal and fetal risks.
  • Measures to control nausea or vomiting:
  • Continue treatment until the patient can tolerate oral fluids and until test results show little or no ketones in the urine.
  • This may provide comfort, but be cautious and aware of the effects of muscle and weight loss due to too much bed rest.
  • Medication (varies and may have other unwanted side effects).
  • Tube Feedings.
  • Homeopathic remedies are a non-toxic system of medicines. Do not try to self medicate with homeopathic methods; have a homeopathic doctor prescribe the proper remedy and dose.
  • improving nutrition and weight gain .
  • Eat a diet high in protein and complex carbohydrates, both of which fight nausea.
  • Medications metoclopramide (Catergory B) , antihistamines and antireflux medications.