HIPEREMESIS GRAVIDARUM

1. BACKGROUND OF HIPEREMESIS GRAVIDARUM
Pregnancy is a physiological process that occurs in women. Pregnancy begins from conception until birth of the fetus. Based on the WHO study it is found throughout the world for 500,000 deaths per year during pregnancy or delivery and the neonatal infant mortality, especially for 10,000,000 inhabitants per year during pregnancy or delivery.
Educating pregnant women is need to be done because many pregnant women do not understand the importance of prenatal care, especially the extension of complications as a result of pathological pregnancy, one of them is "Hyperemesis Gravidarum". Maternal Mortality is expected in Indonesia decreased by 75% in 2010 from the year 1990. In Indonesia in 2010 later, it is mentioned that in 2010 the number of pregnancy and delivery in Indonesia can be manifasted and service standards can be improved by every medical staff.

2. DEFINITION OF HIPEREMESIS GRAVIDARUM
Hyperemesis gravidarum is a severe form of morning sickness, with unrelenting, excessive pregnancy-related nausea and/or vomiting that prevents adequate intake of food and fluids.

3. SYMPTOMS OF HYPEREMESIS GRAVIDARUM
There are many symptoms of hyperemesis gravidarum. A woman who has experiences the following symptoms should notify her obstetrician:
• Nausea accompanied by uncontrolled vomiting
• Inability to keep any food down
• Nausea and/or vomiting that does not get better after the first trimester (about 12 weeks gestation)
• Severe dehydration
• Food aversions
• Loss of 5 percent or more of mother’s pre-pregnancy weight
• Decreased urination
• Headaches
• Confusion
• Jaundice
• Fainting

4. CAUSE OF HIPEREMESIS GRAVIDARUM
No one knows for certain what causing hyperemesis gravidarum. May be a genetic tendency having extreme morning sickness; sisters or daughters of women with hyperemesis gravidarum have a higher incidence of having it than women with no family history of hyperemesis gravidarum. Also, women who have had it in previous pregnancies are more likely to have hyperemesis gravidarum again. Some have suggested that the bacteria Helicobacter Pylori may contribute to hyperemesis gravidarum, but the scientific data is inconclusive about whether this is actually a contributing factor or not.

5. MEDICAL TREATMENT OF HPEREMESIS GRAVIDARUM
Below are several which are commonly used to treat HG and are believed to be safe :
• The standard treatment in most of the world is Benedictin (also sold under the trademark name Diclectin), a combination of doxylamine succinate and vitamin B6.
• Antiemetic drugs, especially ondansetron (Zofran)
• Metoclopramide is sometimes used in conjunction with antiemetic drugs; however, it has a somewhat higher incidence of side effects.
• Other medications less commonly used to treat HG include Marinol, corticosteroids and antihistamines.




6. PREVENTION OF HYPEREMESIS GRAVIDARUM
Although there isn’t evidence that hyperemesis gravidarum can be prevented. Several strategies may help lessen the nausea and vomiting. Some of them are :
• Eating dry foods and limiting fluid intake may also be helpful
• Small meals should be eaten frequently throughout the day, with a protein snack at night.
• Eating soda crackers before rising from bed in the morning may help prevent early morning nausea.
• Iron supplements may cause nausea and can be eliminated until the nausea is controlled.
• Sitting upright for 45 minutes after meals may also help.

7. CONCLUSION
Hyperemesis gravidarum is severe morning sickness that affects some pregnant women. It can make dehydration, electrolyte imbalance and malnutrition. Many pregnant women experience “morning sickness,” nausea and vomiting that can occur at any time of day. Hyperemesis Gravidarum can prevented with lessen of the nause and vomiting.