A.

Definition
Hyperemiss Gravidarum is over gag and neusea to pregnant women till disturb their
daily activity and its generally being bad cause dehidration. Neusea aand gag happens in the
morning but can be every moment even in the night. This Symptoms happen less than 6
weeks after first day and happen for more than 10 weeks.
B. Etiology
Cause of hyperemesis gravidarum still unknown. Frequency of this is 2 per 1000 pregancy.
1. Generally happens to primigravid, molahidatidose, diabetes and twin pregnancy effect
HCG enhacement
2. Organic Factor,
3. Stress

Feeling of Neusea is effect from increased of estrogens which usually happen in 1st
trimester.

C. Symptoms and Signs

Hyperemesis gravidarum. According to light and heavy devided in 3 levels, :
a. 1st level (light)
Neusea and gag in continuity which influence sufferers general circumtences
Sufferes feel tired
Less appettite
Feels pain at the epigastrium
Pulse improve till 100 per minute
Blood pressure
Less Skins turgor
Dry tongue
Sunken eyes
b. 2nd level
Patients seem weaker and more apathetic
Skin turgor is getting worse
The tongue dries and looks dirty
The pulse is small and fast
Body temperature rise (dehydration)
The eyes begin to jaundice
Weight loss and sunken eyes
Tension drops, hemoconcentration, oliguri and constipation
Acetone smells from the air and acetonuria occurs
c. Tier III (weight)
General conditions are more severe (awareness decreases from somnolent to
coma)
Severe dehydration
Small pulse, fast and smooth
The body temperature increases and the tension falls
Fatal complications arise in the nervous system known as wernicke encelopathy
with symptoms of nystagmus, diplopia and mental decline
 The jaundice of jaundice
D. PREVENTION
The principle of prevention is to treat emesis in order to avoid hyperemesis gravidarum
by:
Provide information about pregnancy and childbirth as a physiological process
Provides confidence that nausea and sometimes vomiting are physiologic
symptoms in young pregnancies and will disappear after 4 months of pregnancy
Advise changing daily meals with small but frequent meals
Advise in the morning do not get out of bed, first eat dry bread or biscuits with
warm tea.
oily and fatty foods should be avoided
Food should be served hot or very cold
Regular defects
Avoiding carbohydrate deficiency is an important factor, it is recommended
foods that contain lots of sugar
E. MANAGEMENT
By providing information and education about pregnancy in mothers with the intent
of eliminating the psychic factor of fear. Also about pregnant women's diets, eat small
portions / little-but often. Do not stand up when you wake up in the morning, will feel,
nausea and vomiting. Defecation should be cultivated regularly. (Ida Ayu C. Manuaba, 2008).
a. Drug Therapy
Drug therapy is given if the above does not reduce complaints and symptoms. But
keep in mind not to give teratogenic drugs. May use sedativa (luminal, stesolid), vitamins
(BI and B6), anti-vomiting (mediamer B6, dramamine, acopreg, avomin, torecan)
antacids and anti-heartburn
b. Psychological Therapy
It should be reassured to the patient that the disease can be cured by eliminating
fear by pregnancy
c. Parenteral Fluids
Parenteral fluids are given enough electrolytes, carbohydrates and proteins with 5%
glucose in physiologic saline fluids of 2-3 liters a day. If necessary can be added
potassium and vitamins, especially vitamin B complex and vitamin C