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Hyperemesis Gravidarum

Hiker-vomiting while Pregnant
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Excessive vomiting to the point of weight loss, electrolyte imbalance, nutritional deficiencies, and ketonuria characterize the condition of hyperemesis gravidarum. This condition does not affect all pregnancies (less than 0.5%). The etiology is unknown, but many attribute high levels of estrogen or hCG, along with gastroesophageal reflux and reduced gastric motility as causative factors. Most patients can be managed on an outpatient basis; however, in severe cases hospitalization is required.
8 KEY FACTS
SIGNS AND SYMPTOMS
Excessive Vomiting
Excessive Vomit

Hyperemesis gravidarum is characterized by excessive vomiting. Excessive vomiting can cause significant weight loss, nutritional issues, and metabolic imbalances.

Significant Weight Loss
Baggy-pants

When vomiting becomes severe enough, the pregnant woman may experience significant weight loss. This is an issue that must be addressed with the health care provider.

Dehydration
Empty-canteen

Increased vomiting can result in loss of fluids and dehydration. The woman may require IV fluid replacement in order to improve fluid balance.

Hypotension
Hippo-BP

Hyperemesis gravidarum can cause significant fluid loss. If this persists, the pregnant woman may experience hypotension. Hypotension may decrease tissue perfusion and perfusion to the fetus; therefore, it is important to correct the hypotension.

Electrolyte Imbalance
Electric-lights Scale

Excessive vomiting can result in electrolyte imbalances and alterations in pH. As stomach acid is exiting the body, the woman’s pH may lead to metabolic alkalosis.

INTERVENTIONS
Antiemetics
Ant-tie Medics

Antiemetics may be recommended to decrease nausea and vomiting so that the pregnant woman can retain fluids, minimize dehydration, and prevent hypotension. These medications include ondansetron, promethazine, and metoclopramide.

Frequent Small Meals
Frequent Small Meals around the clock

Small frequent meals are suggested for the woman with hyperemesis gravidarum in order to prevent nausea and vomiting. Limited fluids and bland carbohydrates may aid in settling the stomach.

IV Therapy
IV Therapeutically-massaging

IV therapy may be recommended for the pregnant woman in order to replace fluids lost from excessive vomiting. IV fluids are also helpful in treating hypotension that the woman may develop. In addition, electrolytes can be incorporated into the IV fluids to correct electrolyte imbalances and altered pH.

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