TAILIEUCHUNG - Hyperemesis gravidarum

The factors associated with hyperemesis are pri-pregnancy. Support for this idea comes from the marily maternal and fetal factors that are not easily fact that many of the foods that tend to repulse modifiable, but their identification may be useful in pregnant women contain potentially harmful sub-determining those women at high risk for develop-stances. | 4 Hyperemesis Gravidarum Shipra Sonkusare INTRODUCTION Nausea and vomiting of pregnancy has been a very common age-old phenomenon. Although not well understood it occurs in almost 70 of pregnant women. While morning sickness remains common it is usually more troublesome when it is serious. The traditional practice of giving the symptomatic antiemetic treatment without much knowledge and confidence has not changed over the years. The severe end of the continuum hyperemesis gravidarum may complicate up to of pregnancies causing pathological changes that may affect the mother and fetus. In most cases affected individuals progress from mild or moderate nausea and vomiting to hyperemesis gravidarum which can be complicated or uncomplicated the former referring to acetonuria fluid electrolyte imbalance and Wernicke s encephalopathy. Prematurity low birthweight small for gestational age and a 5-min Apgar score of 7 have been reported in fetuses of mothers affected with hyperemesis gravidarum level of evidence II-2 more so in women with poor maternal weight gain associated with it. ETIOLOGY The cause of hyperemesis is still not well understood. The associated risk factors and the significance of these associations are depicted in Table 1. The factors associated with hyperemesis are primarily maternal and fetal factors that are not easily modifiable but their identification may be useful in determining those women at high risk for developing hyperemesis and some might give clues on the choice of treatment as in hyperthyroidism and diabetes. High risk for recurrence is observed in women with hyperemesis in the first pregnancy. The risk is reduced by a change in paternity. For women with no previous hyperemesis a long interval between births slightly increases the risk of hyperemesis in the second pregnancy. So relative impact of genetic and environmental factors and their possible interactions is also seen in hyperemesis1. A low pre-pregnancy weight to height ratio may

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