Hyperemesis Gravidarum and Obstetric Outcome

Abstract

Aims: This study was conducted to evaluate maternal characteristics and obstetric outcomes among women with hyperemesis gravidarum during pregnancy. Methods: A prospective hospital based study was conducted at Nepal medical college and teaching hospital over the period of two years where all the women admitted with history of hyperemesis gravidarum were evaluated. Hyperemesis gravidarum was defined as intractable nausea/vomiting in pregnancy that leads to dehydration, nutritional deficiency, electrolyte and metabolic disturbances and considerable ketonuria that may require hospitalization. The age of women, parity, gestational age, method of treatment and duration of hospital stay were analysed.The fetal outcome evaluated were incidence of preterm birth, apgar score <7 at 5 mins of birth, low birth weight, perinatal deaths and congenital anomalies in baby. Results: There were 52 women admitted with hyperemesis gravidarum among all obstetric admission (N= 2080). The incidence of hyperemesis gravidarum was 2.5% of all pregnancy. The condition was seen more commonly in nulliparous (61.5%) than in multiparous women. It was less common in women of parity 3 or more. The problem was identified maximum (50%) in gestational age of 5-7 weeks though one case was seen in gestational age of 20 weeks also. The mainstay of treatment was supportive. The range of hospital stay was 1-10 days with mean hospital stay 2.26 days. The preterm delivery rate was 4.8% and none of the babies were low birth weight. All the babies had apgar score >7 at 5 mins of birth. There were no congenital anomalies and no perinatal deaths were noted. Conclusions: Women with hyperemesis gravidarum did not have adverse obstetric outcome in this study. NJOG 2011 Nov-Dec; 6 (2): 24-26 DOI: http://dx.doi.org/10.3126/njog.v6i2.6752

Prevalence of hyperemesis gravidarum using the 24-hour pregnancy unique quantification of emesis scale scoring-a descriptive study

“…14 In another study done in Nepal by Giri et al the condition was seen at gestational age of 5-7 weeks in 50% of the patients which is lower in comparision to our study findings. 4 In our study, 43 (74.3%) multigravida had history of hyperemesis in their previous pregnancy. However, in the study conducted by Chhetry et al found that previous history of HG was 16 (24%).…”

“…1 In study done by Giri et al the mean hospital stay was 2.26 days and the range being 1-10 days. 4 The mean number of hospital stay in the study done by Konikoff et al was 2.24±2.2. 16 In a large cohort study done on elective termination of pregnancy done by Poursharif et al 123 women (15.2%) reported at least one elective termination of pregnancy due to HG.…”

“…In a study done by Giri et al (61.5%) and Heitmann et al (62.8%) similar finding were observed. 4,8 In another study conducted by Chhetry et al 51% of patients were primigravida. 14 Also in study conducted by Dodds et al 48.7% of the enrolled patients with HG were primigravida which is similar as in this study.…”

“…However, 10% to 20% of affected women experience symptoms throughout pregnancy and in 10% symptoms may even persist in postpartum period. 3,4 It a diagnosis of exclusion wherein other causes of severe vomiting are excluded. 5 The PUQE-24 appears to be a reliable tool for assessing the prevalence of severity of NVP symptoms.The aim of this study was to determine the grade of nausea, vomiting in pregnancy using PUQE-24 scoring system in Kathmandu medical college public limited.…”

An Increased Adverse Fetal Outcome Has Been Observed among Teen Pregnant Women in Rural Eastern Ethiopia: A Comparative Cross-Sectional Study

“… 66 Also, a study conducted in Nepal showed the association of preterm babies and HG. 67 HG has different physiological consequences for the mother, such as dehydration, electrolyte imbalances, and severe loss of weight, as well as concern about the effects of babies. 68 …”