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Chapter: Obstetric and Gynecological Nursing : Abnormal Pregnancy

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Hyper Emesis Gravidarum

Excessive vomiting in pregnancy is a rare condition found in approximately 1 in 500 pregnancies.

Hyper Emesis Gravidarum

 

Excessive vomiting in pregnancy is a rare condition found in approximately 1 in 500 pregnancies. Nausea and vomiting exists and dehydration and keto-acidosis escalate with the result that the serum electrolyte balance is disrupted. Cause:- It is unclear but it is known to be associated with:

 

·                 Multiple pregnancy

 

·                 Hydatidiform mole

 

·                 A history of unsuccessful pregnancies

 A proportion of women who experience this condition will have a recurrence in subsequent pregnancies.

 

Assessing the mother’s condition

 

·                 Ask the woman whether normal diet has been resumed and tolerated.

·                 Identify any events producing stress or anxiety, as these may exacerbate any vomiting.

·                 Ascertain whether the nausea and vomiting are accompanied by pain; the location of any pain should be elicited.

·                 Dryness or inelasticity of the skin

·                 The mother’s weight will be less than expected for gestation.

·                 The pulse rate will be weak and rapid and the blood pressure will be low.

·                 The urine will smell of acetone, be scant and dark in colour

·                 It is usual for a mother suffering from hyper emesis gravidarum to be admitted to hospital.


Treatment


Calm, reassurance and giving sensitive information should be accompanied by competent attention to physical needs.

The potassium and sodium levels will be corrected by intravenous therapy.

The infusion will be continued until hydration and electrolyte return to normal.

Vitamin B12 and C, folic acid and iron will be required to correct the anaemia.

Observe the blood pressure, pulse rate and temperature at least 4-hourly.

Measure the intake and out put of fluids, including vomitus,


Once vomiting has ceased for a period of 24 hours oral fluid may be commenced and if these are tolerated a light diet may follow. Normal food is gradually introduced and intravenous therapy discontinued.


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