Definition:-
“Hyper emesis gravid arum is excessive nausea and vomiting during pregnancy. This pernicious vomiting is differentiated from the more common and normal morning sickness by the fact that it is of greater intensity and extends beyond the first semester.”
Causes:-
• High levels of HCG or undue sensitivity to normal levels of HCG may cause vomiting.
• Psychological factors- Women with a previous history of hyper emesis are likely to experience it in subsequent pregnancies.
• An allergic factor- It may also be operative, since large amounts of histamine are found in cases of hyper emesis.
Sign and Symptoms:-
• Pernicious vomiting.
• Poor appetite and poor nutritional intake.
• Loss of more than 25 percent of body weight.
• Acidosis due to starvation.
• Low urine output.
• Rapid pulse and low blood pressure.
• Hem concentration with rising blood urea nitrogen and falling sodium, potassium and chloride.
Complication:-.
• Debilitating, chronic nausea
• frequent vomiting of bile or blood
• Chronic ketosis and dehydration
• Muscle weakness and extreme fatigue
• Medication does not stop vomiting/nausea
• Inability to care for self (shower, prepare food)
• Loss of over 5-10% of your pre-pregnancy weight
• Weight loss (or little gain) after the first trimester
MANAGEMENT-
In some cases hyper emesis gravid arum is so severe that hospitalization may be required.
Hospital treatment may include some or all of the following:
• Intravenous fluids (IV) – to restore hydration, electrolytes, vitamins, and nutrients
• Tube feeding:
o Nasogastric – restores nutrients through a tube passing through the nose and to the stomach
o Percutaneous endoscopic gastrostomy – restores nutrients through a tube passing through the
Abdomen and to the stomach; requires a surgical procedure
• Medications – metoclopramide, antihistamines, and ant reflux medications.
Other treatments may include:
• Bed Rest –This may provide comfort, but be cautious and aware of the effects of muscle and weight loss due to too much bed rest.
• Acupressure
• Herbs – ginger or peppermint
• Homeopathic remedies are a non-toxic system of medicines. Do not try to self medicate with homeopathic methods; have a doctor prescribe the proper remedy and dose.
• Hypnosis
