What is hyperemesis gravidarum slide share?
What is hyperemesis gravidarum slide share?
Hyperemesis Gravidarum is defined as protracted Nausea and Vomiting of Pregnancy with the triad of • > 5% pre pregnancy weight loss • Dehydration and • Electrolyte imbalance. 4. INCIDENCE • The incidence of women with severe symptoms vary from 0.3 to 3 % of pregnancies.
What is the pathophysiology of hyperemesis gravidarum?
Causes. Most women have some nausea or vomiting (morning sickness), particularly during the first 3 months of pregnancy. The exact cause of nausea and vomiting during pregnancy is not known. However, it is believed to be caused by a rapidly rising blood level of a hormone called human chorionic gonadotropin (HCG).
What are possible complications of hyperemesis gravidarum?
Complications of Hyperemesis Gravidarum The main risks to women with hyperemesis gravidarum are dehydration, electrolyte imbalances, and weight loss. Women with prolonged hyperemesis gravidarum are at greater risk for preterm labor and preeclampsia, according to the HER Foundation.
What is the nursing management of hyperemesis gravidarum?
Reestablishing normal fluid and electrolyte levels often relieves nausea and vomiting. Encourage the patient to eat, and tell her to avoid going for a long period without eating. Advise her to eat when she feels hungry, starting with small, frequent lowfat meals. She should avoid drinking fluids with meals.
How is hyperemesis gravidarum diagnosis?
The diagnosis of hyperemesis gravidarum may be confirmed by a thorough clinical evaluation, detailed patient history, and the identification of characteristic symptoms (e.g., persistent and severe nausea and vomiting, dehydration, and weight loss).
How do you prevent hyperemesis gravidarum?
If women develop hyperemesis, the American College of Obstetrics and Gynecology recommends lifestyle changes. Examples include eating small, frequent meals that are high in protein; avoiding spicy, fatty, or oily foods; and not taking a prenatal vitamin that contains iron.
What electrolyte imbalances occur with hyperemesis gravidarum?
Serum electrolyte imbalances of patients with hyperemesis may result in severe hypokalemia. Potassium abnormalities have been reported to increase the mortality in pregnant women with hyperemesis. Besides, severe hypokalemia may cause rhabdomyolysis in the setting of HG [8].
Why is dextrose contraindicated in hyperemesis gravidarum?
Solutions which contain dextrose should not be given to patients suffering from hyperemesis gravidarum. This is because dextrose increases your body’s need for thiamine. Hence, the chances of precipitating Wernicke encephalopathy gets higher in women who already suffer from thiamine deficiency.
What is the second line treatment for hyperemesis gravidarum?
Add an antihistamine (H1 antagonists) — If doxylamine-pyridoxine (see ‘Doxylamine-pyridoxine’ above) has been ineffective, it should be discontinued before starting a different antihistamine. We suggest the following antihistamines as second-line agents for patients who are vomiting.
Why is pyridoxine given for hyperemesis gravidarum?
The American College of Obstetrics and Gynecology recommends that first-line treatment of nausea and vomiting of pregnancy should start with pyridoxine (vitamin B6) with or without doxylamine. Pyridoxine has been found to be effective in significantly reducing severe vomiting but is less effective with milder vomiting.
Which IV fluid is best in pregnancy?
Intravenous (IV) fluids should be provided to replenish the lost intravascular volume. Rehydration along with replacement of electrolytes is very important in the treatment of hyperemesis. Normal saline or Hartmann solution are suitable solutions; potassium chloride can be added as needed.
What is the drug of choice in hyperemesis gravidarum?
Ondansetron (Zofran), while pregnancy Class B, has become the most common parenteral and oral antiemetic used in US emergency departments due to its efficacy, and it has become the first choice in hyperemesis in the last several years—especially since it became available in a generic form.
What is the drug of choice for hyperemesis gravidarum?
What IV fluid is best for hyperemesis?
Intravenous Fluids Rehydration along with replacement of electrolytes is very important in the treatment of hyperemesis. Normal saline or Hartmann solution are suitable solutions; potassium chloride can be added as needed.
Why dextrose is avoided in hyperemesis gravidarum?
In HG patients with severe thiamine deficiency (which can occur after prolonged starvation), dextrose infusion can cause a condition called Wernicke’s encephalopathy. To prevent this, before starting rehydration, all participants will receive a multivitamin intravenous injection containing thiamine.
Why is dextrose contraindicated in hyperemesis?
Which IV fluid is best for hyperemesis gravidarum?
What causes hyper emesis gravidarum?
Theories behind Hyper emesis Gravidarum 1.HORMONAL • High Hcg-Hydratiform mole, multiple pregnancy • High Estrogen • High progesterone-relaxation of cardiac sphincter • Other hormones involved: -Thyroxin -Prolactin -Leptin -Adreno-cortisol hormones 7. 2.PSYCHOGENIC It probably aggravated nausea once it begins it trigger neurogenic elements .
What is the meaning of hyperemesis gravidarum?
Hyperemesis Gravidarum. By: Dr. Ayman Bukhari. DEFINITION :. Persistent vomiting accompanied by weight loss exceeding 5 percent of prepregnancy body weight and ketonuria unrelated to other causes Although , I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
What is the incidence of hyperemesis gravidarum in the US?
The incidence vary from 0.3 to 2 %. • Hyperemesis tends to improve in the last half of pregnancy, but may persist until delivery. • If vomiting persists beyond a few days postpartum , other etiologies should be investigated.