“If it matters to you,

you’ll find a way”

Hyperemesis
Gravidarum
Presented by: Maricar C. Abonado
Diploma in Midwifery II
Southern Luzon State University
 Table of contents

About the patient Discussion of the

01 02 Condition

Signs and
03 Diagnosis 04 Symptoms

Pathophysiology of the Intervention and

05 06 Treatment
Condition
Patient’s Profile
• Client name: Patient Q
• Age/sex: 24 y/o Female
• Father/spouse name: Mr. R
• Ward: 10
• Bed No.: 140
• Address: Lucena City, Philippines
• Education: College Level
• Marital status: Married
• Date of admission: February 19,
2021
• Date of discharge: February 24,
2021
• Diagnosis: Hyperemesis
Gravidarum
• Doctor In-charge: Dr. Sam
Medical History
GTPAL: G2 T1 P0 A0
L1
Complaints of
persistent vomiting LMP: Dec. 30, 2020
and nausea as well as AOG: 7 weeks and 2 Nothing
weight loss, starvation, Significant
and constipation. days
EDC: October 06, 2021

Chief Present medical Past Surgical

complaints: history: History:
Having hyperemesis
gravidarum in previous
pregnancy Patient’s Social History:
• Past surgical history:
• Social Class: Middle-
Nothing significant
• Patient’s Family History: income class
There are 3 members in • Nationality: Filipino
patient’s family, all members
• Religion: Catholic
are physically and mentally
well being. • Occupation: Teacher
Nutrition focused Physical
Assessment

Appearance: Pale,
dehydrated and
weight loss
Physical Examination
Build: Thin Skin: Dryness is present
Height: 5’2 Pallor: Absent
Weight; 40 Jaundice: Present
Back: Spine is normal, skin is intact
HEAD TO TOE Bowel and Bladder: Constipation present

Scalp: Clean
Hair: Black in color
Face: absence of swelling of eyes, nose, lips and mouth
Teeth: Complete teeth, No bleeding present from gums
Neck: Symmetry to the body, swelling of lymph nodes is
absent
Upper Extremities: No deformity present, capillary refill is
less than 3 sec., swelling is absent
Legs: Swelling of both legs is absent, Absence of homan’s
 Vital Signs
Vital Signs Patient’s Value Normal Values Remarks
Temperature 38°C 36.1°C – 37.2°C Above Normal
Pulse 120 bpm 60 – 100 bpm Above Normal
Respiration 20 bpm 12 – 18 bpm Above Normal
Blood Pressure 90/70 mm Hg 120/80 mm Hg Below Normal
Laboratory Test
Lab test Patient’s Value Normal Values Remarks
Hemoglobin 10.8 mg/dl 11-13mg/dl Normal
Urine (protein) 4.3mg/dl 3.6-4 mg/dl Above Normal
Albumin
108mg/dl 70-110mg/dl Normal
Blood Sugar
2.7mIu/L 0.6-4.0 mIu/dL Normal
TSH 6.8 mg/dl 5.6-11.5 mg/dl Normal
T4 - 80-220 mg/dl -

T3
Sodium 120mEq/L 135-165mEq/L Below Normal
Electrolytes 4.2mEq/L 3.5-5.0 mEq/L Normal
Sodium 90 mEq/L 96-109 mEq/L Below Normal

Potassium
Chloride
FDR
WHAT IS
HYPEREMESIS
GRAVIDARUM?
• Vomiting is a symptom which may be
related to pregnancy or maybe a
manifestation of some medical
surgical-gynecological complications.

Classification:
• Emesis Vomiting
• Hyperemesis Gravidarum
Hyperemesis Gravidarum
Hyper Emesis Gravidarum
Increase Vomiting Pregnancy

 Severe type of vomiting of pregnancy with harmful or serious effect on the health of
the mother.

 Results in dehydration, weight loss, nutritional deficiencies, abnormal electrolyte and

acid base balance
 Risk Factors

Hyperemesis gravidarum Being overweight Having a multiple

during an earlier pregnancy. pregnancy.

The presence of trophoblastic disease, which involves

Being a first-time mother the abnormal growth of cells inside the uterus.
Diagnosis
Through measurement of
urine ketones, serum
electrolytes, and renal
function.
 Signs and
Symptoms
 Prolonged and severe nausea and vomiting being
dehydrated.

 Symptoms of dehydration include, feeling thirsty, tired,

dizzy or lightheaded, not peeing very much, and having
dark yellow and strong-smelling pee

 Weight loss

 Jaundice

 Low blood pressure (hypotension) when standing

Pathophysiology of the Condition
Intervention and treatment for Hyperemesis
Gravidarum
Preventive measures: These might include a pressure-point
wristband similar to those used for motion sickness vitamin B6
and/or ginger.

Sea-band
Mama
Small frequent meals: Nausea and vomiting might be treated with
dry foods (such as crackers) and small, frequent meals.
Intravenous fluids: It is important for a pregnant woman to maintain her fluid
intake. Intravenous (IV) fluids might be needed if a woman continues to vomit
throughout pregnancy. In severe cases, the woman might require hospitalization
and given IV fluids. IV fluids might be discontinued when a woman is able to
take in fluids by mouth.

0.9% Normal Saline (NS, 0.9NaCl, or NSS) is

one of the most common IV fluids, it is
administered for most hydration needs:
hemorrhage, vomiting, diarrhea, hemorrhage,
drainage from GI suction, metabolic acidosis, or
shock.
Total parenteral nutrition: The most severe cases of hyperemesis
gravidarum might require that complex, balanced solutions of nutrients be
given through an IV throughout pregnancy. This is called total parenteral
nutrition (TPN).
Medicines: To prevent nausea is used when vomiting is persistent and
poses possible risks to the mother or baby. If a woman cannot take
medicines by mouth, the drugs might be administered through an IV or
a suppository. Medicines used to prevent nausea include Promethazine,
Meclizine and Droperidol.
Monitor ECG (Electrocardiogram)
REFERENCES
● https://www.youtube.com/watch?v=OGdHimyPq2g
● https://www.youtube.com/watch?v=iSH-t8cuqFs
● https://youtu.be/-xTdhz5rksc
● https://d3i71xaburhd42.cloudfront.net/0a3c255bc348a0a1c2b3029d8f1121c9181c5c46/2-Figure1-1.png
● https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting/
● https://www.slideshare.net/emschumann/hyperemesis-case-study
● https://www.youtube.com/watch?v=iSH-t8cuqFs
 SHORT QUIZ

• DEFINED AS THE PERSISTENT AND SEVERE

NAUSEA AND VOMITING DURING PREGNANCY

• GIVE THE SIGNS AND SYMPTOMS OF

HYPEREMESIS GRAVIDARUM

• RISK FACTORS OF HYPEREMESIS GRAVIDARUM

THANK YOU!