Severity of Hyperemesis Gravidarum and Associated Maternal factors

Abstract

Background: Hyperemesis gravidarum is the most severe form of nausea and vomiting in pregnancy. It is one of the most common cause of early pregnancy admissions and associated with various maternal risk factors . Very few studies have been conducted among Nepalese women with hyperemesis gravidarum. This study aims to identify various maternal risk factors among Nepalese women and its severity using pregnancy unique quantification of emesis scoring. Methods: This is a cross sectional observational study conducted at Paropakar Maternity and Women’s Hospital. Total duration of the study period was for one year from February 2018 to Janurary 2019. A total of 144 patients meeting the inclusion criteria were included in the study.The severity of the hyperemesis gravidarum was assessed and classified using pregnancy unique quantification of emesis scoring. Various maternal demographic, obstetric and personal factors were studied in relation to the incidence and severity of hyperemesis gravidarum.Results: Moderate (49.30%) to severe(50.69%) hyperemesis gravidarum were admitted in the hospital. Most women were nulliparous from 20-24 years age group. Among all categories of BMI, underweight had more severe hyperemesis gravidarum (63.63%) and overweight patient had increased incidence of moderate hyperemesis gravidarum (66.66%). Women with previous dysmenorrhea had severe hyperemesis gravidarum (54.05%) and non-smoker had severe hyperemesis gravidarum (52.03%) while smoker had moderate hyperemesis gravidarum (57.14%).Conclusions: Pregnant women of age group of 20-24 years, nulliparity and underweight were associated with severe hyperemesis gravidarum. Keywords: Hyperemesis gravidarum; maternal factors ; pregnancy unique quantification of emesis.

Comparative Analysis of Maternal and Fetal Outcomes of Pregnancies Complicated and Not Complicated with Hyperemesis Gravidarum Necessitating Hospitalization

“…Although the exact etiology of HG remains unknown, it is considered to be a multifactorial disease 2 . Age group of 20-24 years, nulliparity and underweight were reported to be the factors associated with severe hyperemesis gravidarum 19 . The characteristics of women with hyperemetic pregnancies in the current study cohort support the higher likelihood of younger (vs. older) maternal age, nonsmoker (vs. active smoker) status and primiparity (vs. multiparity) in pregnancies complicated by HG 2,20,21 .…”

The Prevalence and Risk Factors of Hypokalemia in Pregnancy-Related Hospitalizations: A Nationwide Population Study

“…Congestive heart failure has been well known to cause hyperkalemia by decreasing the effective intravascular volume and renal perfusion [15]. However, the possible explanation of the association with hypokalemia in pregnant patients is that it could be secondary to diuretics use or an altered RAAS [8][9][10]. Cortisoladrenal insufficiency is also reported to be associated with hyperkalemia by decreasing potassium excretion.…”

The role of hematological parameters in the diagnosis of hyperemesis gravidarum

“…Nutritional disorders, dehydration, electrolyte disorders, weight loss, and ketonuria can also be added to the picture, which may worsen the clinical course of the pregnant woman. Hyperemesis gravidarum, which can develop in almost 2% of pregnant women, may be at a level that may require hospitalization in some patients [1][2][3][4][5]. A wide variety of factors play a role in the development of hyperemesis gravidarum.…”

“…A wide variety of factors play a role in the development of hyperemesis gravidarum. These include increased beta-HCG level, steroids, multiple pregnancy, increased body mass index, and a history of hyperemesis gravidarum, but the exact cause of the hyperemesis has not been elucidated [3][4][5]. Serious complications can also be developed in some pregnant women with hyperemesis gravidarum such as Wernicke encephalopathy and thromboembolism, preterm birth, low birth weight, retarded growth, some congenital anomalies, and fetal death.…”

“…Serious complications can also be developed in some pregnant women with hyperemesis gravidarum such as Wernicke encephalopathy and thromboembolism, preterm birth, low birth weight, retarded growth, some congenital anomalies, and fetal death. Therefore, it is necessary to closely monitor the hyperemesis gravidarum, and it is important to provide supportive treatment to these pregnant women quickly [3][4][5][6][7]. In chronic inflammation, proliferation is observed in the megakaryocytic series, which leads to the emergence of relative thrombocytosis.…”