Michaella Menor
BSN 2A
NCM 109 Lecture
Topic: Hyperemesis Gravidarum
Vomiting – a symptom which is related to
pregnancy or maybe manifestation of some
medical-surgical-gynecological
complications, which can occur anytime at
pregnancy.
Introduction
- 80% of women exp vomiting
- Morning sickness the term describes
this condition that usually disappear
after 1st trimester (imbalanced
electrolyte if nag occur after 1st
trimester which is not normal)
- Common in early pregnancy (about
50%)
- Features disappears with/without
treatment within 12-14th week of
pregnancy
Management of Morning Sickness
- Assurance
- Dry toast or biscuit and voidance of
fatty or spicy food
- Vit B1 supplementation 100mg daily
- Antiemetic drugs: promethazine
Definition: Unlike morning sickness, HG is a
complication of pregnancy characterized by
persistent uncontrollable nausea and
vomiting that persists beyond the 20th week
of pregnancy
- Malnutrition and other serious
complications such as electrolyte or
fluid imbalances
S/sx
- Loss of 5% weight or more of pre
pregnancy weight
- Dehydration, causing ketosis and
constipation
- nutritional disorders such as vit B1,
B12 or vit B6 deficiency
- Metabolic imbalances such as
metabolic ketoacidosis or
thyrotoxicosis
- Sx can be aggravated by hunger,
fatigue, prenatals vitamins (esp
containing iron), and diet
Causes
- Adverse reaction to the hormonal
changes of pregnancy in particular,
elevated levels of beta human chorionic
gonadotropin (HCG)
HCG – hormone for maintaining
pregnancy; signaling production of
estrogen and progesterone
Mabawasan dapat ang HCG during 12-14
week of pregnancy para magdecline ang
vomiting since developed na ang placenta
to produce estrogen and progesterone
Pathogenesis
Psychological Factors
Conversion or Response to Stress
Somatization
disorder
Hormonal Changes
- Estrogen up
- Progesterone up
- Beta hCG up
Natural Course
- Main onset of sx – 5-6 weeks of
gestation
- Peak – 9 weeks
- Subsides by 16-20 weeks of gestation
Complications
1. Weight loss
2. Dehydration
3. Metabolic acidosis from starvation
4. Alkalosis from loss of HCI
5. Hypokalemia (electrolyte imbalance)
Dx
- Affected ang developing fetus
- Associated with serious and fetal
mobility such as Wernicke’s
encephalopathy
Management
1. Promoting Fluid and nutritional
balance
2. Promoting Comfort
3. Providing Support and education
