Analysis of Pregnant Woman with Hyperemesis Gravidorum in a Tertiary Care Center

Hyperemesis gravidarum (HG)is a pregnancy complication that is characterized by severe nausea, vomiting, weight loss, and possibly dehydration.[1] Hyperemesis gravidarum is extreme, persistent nausea and vomiting during pregnancy. It can lead to dehydration, weight loss, and electrolyte imbalances. Morning sickness is mild nausea and vomiting that occurs in early pregnancy. Often symptoms get better after the 20th week of pregnancy but may last the entire pregnancy duration.[2]

The exact causes of hyperemesis gravidarum are unknown.[3] Risk factors include the first pregnancy, multiple pregnancy, obesity, prior or family history of HG, trophoblastic disorder, and a history of eating disorders.[3][4] Diagnosis is usually made based on the observed signs and symptoms.[3]

Treatment includes drinking fluids and a bland diet. With respect to medications pyridoxine or metoclopramide are preferred.[5] Prochlorperazine, dimenhydrinate, or ondansetron may be used if these are not effective.[3][5] Hospitalization may be required in severe cases. Hyperemesis gravidarum is estimated to affect 0.3–2.0% of pregnant women.[6]

While vomiting in pregnancy has been described as early as 2,000 BC, the first clear medical description of hyperemesis gravidarum was in 1852 by Antoine Dubois.[7]

If HG is inadequately treated, anemia,[11] hyponatremia,[8] Wernicke’s encephalopathy,[8] kidney failure, central pontine myelinolysis, coagulopathy, atrophy, Mallory-Weiss tears,[8] hypoglycemia, jaundice, malnutrition, pneumomediastinum, rhabdomyolysis, deconditioning, deep vein thrombosis, pulmonary embolism, splenic avulsion, or vasospasms of cerebral arteries are possible consequences. Depression and PTSD [9] are common secondary complications of HG and emotional support can be beneficial.[8]

Keywords:HG, hyperemesis gravidorum, vomiting in pregnancy, morning sickness, thiamine deficiency, nausea, vomiting in pregnancy, pregnancy, antiemetics, adverse pregnancy outcomes.