A Reading on

HYPEREMESIS GRAVIDARUM

A Journal Reading Presented to the Faculty of San Pedro College

In Partial Fulfillment of the Requirements in NCM 209 - RLE

OB/GYNE WARD NURSING ROTATION

Submitted to:

Sir Julius Alterado, RN

Clinical Instructor

Submitted by:

Immanuel John G. Jurilla, St. N

BSN 2L – GROUP 2

March 15, 2023

Title: Women’s perspectives on the management and consequences of
hyperemesis gravidarum – a descriptive interview study.

Bibliography:
Havnen, G. C., Truong, M. B.-T., Do, M.-L. H., Heitmann, K., Holst, L., &
Nordeng, H. (2019). Women’s perspectives on the management and
consequences of hyperemesis gravidarum – a descriptive interview
study. Scandinavian Journal of Primary Health Care, 37(1), 30–40.
https://doi.org/10.1080/02813432.2019.1569424

Summary:

Hyperemesis gravidarum (HG) is considered the most severe manifestation

of nausea and vomiting in pregnancy. It is a leading cause of hospitalization in
early pregnancy and affects 0.3-3% of pregnant women. HG causes electrolyte
imbalance, dehydration, nutritional deficiency, and weight loss. This study aims
to investigate the treatment and management of Norwegian women with HG and
the consequences of HG to their daily lives.

107 women were included in the study and about ¾ of them were
hospitalized due to HG. the majority showed clinical signs of more than 5%
weight loss (84%), dehydration (79%), and ketonuria (75%). HG was described
by the participants to be severely consequential to their psychosocial and
profoundly impacted their daily activities. Nearly two out of five reported
considering voluntary abortion and eight women had at least one elective
abortion caused by HG. All in all, 20 women (19%) have changed their physician
due to their dissatisfaction of the management of their HG.

In conclusion, other than the major impact of HG to their daily activities and
its severe psychosocial burden, many women with HG lack the proper
management and support from healthcare professionals. To solve this, better
knowledge and awareness among the healthcare professionals is needed in
order to improve the care given to women with HG.
Reaction:
I personally agree with the article in general, it provides great content and
the study presents to be well conducted. It also shows concise data and has a
valuable discussion which tackles the general goal of the paper. Their conclusion
given based on the results that showed dissatisfaction of the management given
to the participants is also agreeable since it is indeed lacking and should be
given more focus by health professionals. Throughout my read, I have realized
how rare HG actually is and how badly it can affect women to the point that they
consider elective abortion. I have also realized how, due to the rarity of the
illness, it is quite mismanaged and treatments are not used well yet.

The paper also gave me insight on the room for improvements in terms of
better management for HG such as, early recognition of all grades of nausea and
vomiting in pregnancy (NVP) can prevent the delay in diagnosis of HG. Also the
recommended use of a tool called the 24-h pregnancy unique quantification of
emesis scoring system (PUQE-24) which can help in both the assessment of the
severity of NVP and the effectiveness of its management.

Now in terms of my personal experience with HG, due to its rarity, I have
none, but I would like to share an experience I have with NVP. When my aunt
was pregnant, she also experienced symptoms of NVP which she then described
as burdensome and it affected her quite badly. It prevented her from doing some
of her daily activities such as morning exercises which are essential in the
management of early pregnancy. Thus, when relating it to HG which have much
more severe symptoms, I start to empathize on what they may be going through
and further makes me agree on the goal of the study.

I believe, and I hope that the article will have a positive impact by allowing
general practitioners (GPs) and healthcare professionals to realize the lack of
management of HG and consequentially improve their perspective and treatment
of the illness. With the data and insights from the participants and the authors
assessment of the present management, the paper can give proper realization
for GPs and that they may also take into consideration the recommendations
given by the authors.

The nursing implications of this article are that it provides valuable

information regarding the current state of HG management which is knowledge
that can be used by nurses and it also gives useful recommendations which are
practical for nursing practices. With the understanding of the article, nurses,
nursing practitioners, and student nurses will be equipped with beneficial
knowledge to be used in their journey throughout their career.