A writing on hyperemesis Gravidarum
Hyperemesis Gravidarum is a condition characterized by severe nausea and vomiting, weight loss and electrolyte disturbance.Mild cases are treated with dietary changes,rest and antacid.More severe cases of ten require a stay in the hospital so that the mother can receive fluid and nutrition through an IV line . It is believed that severe nausea is caused by arise in hormone levels. The symptom of HG usually appear between 4-6 weeks of pregnancy and may peak between 9-13 weeks.
Signs and symptoms of Hyperemesis Gravidarum :
- Severe nausea and vomiting
- Food aversions
- Weight loss of 5% or more of pregnancy weight
- Decrease in urination
- Dehydration — causing ketosis and constipation
- Headache
- Confusion
- Fainting, nutritional disorders such as B1, B6, B12
- Jaundice can be seen
- Extreme fatigue, metabolic imbalances
- Low blood pressure
- Rapid heart rate
- Loss of skin elasticity
- Secondary anxiety and depression
Physical and emotional stress of pregnancy on the body
Treatment :
In some cases , hyperemesis gravidarum is very much serious then patient should admitted in hospital.
Hospital treatment:
IV fluids to restock hydration,electrolytes , vitamin and nutrients.
Tube feeding :
Naso gastric restores nutrients through a tube passing through nose and into the stomach.
Percutaneous endoscopic gastrostomy restores nutrients through a tube and that tube passed through the stomach .some times surgical treatment is also required for that .
Medication:
Metoclopramide , antihistamine and antireflux medication.
Other treatment may include:
Bed rest: This may provide proper comfort but be continuous, and aware of the effects of muscle and weight loss due to too much bed rest.
Acupressure: The pressure points to reduce nausea is located at the middle of inner wrist three fingers length away from the crease of the wrist and between two tendons.
Management:
Dry bland diet / food and oral rehydration are first line treatment.Due to potential for severe dehydration and other complications HG is treated as an emergency.If conservation dietary measure fail ,more extensive treatment such as the use of automatic medication and intravenous rehydration may be required.If oral nutrition is insufficient I.V.nutritional support may be needed.
Medication: A number of anti emetics are effective and safe in pregnancy including pyridoxine , antihistamine and phenothiazines a combination of B6 and doxylamine is effectiveness of HG.
Nutritional support:
Women not responding to IV rehydration and medication may require nutritional support.patient must receive parenteral nutrition like I.V feeding via PICC line or internal nutrition via a nasogastric tube.
Alternative medication :
Acupuncture has been found to be ineffective.The use of ginger products may be helpful but evidence of effectiveness is limited and inconsistent.
Complications : If HG inadequately treated , anaemia, hyponatremia, kidney failure, coagulopathy, atrophy, hypoglycemia, jaundice, malnutrition can be seen. This complications can be treated with proper care and treatment.