Hyperemesis Gravidarum: fetal and maternal complications in a Tertiary Hospital in Nepal

Abstract

Background:  Hyperemesis gravidarum (HG) is a syndrome that occurs in the first half of pregnancy and is manifested by severe vomiting. The vomiting can cause weight loss, dehydration, ketonuria and electrolyte imbalances. Several studies have evaluated the outcome of pregnancies 'complicated' by nausea and vomiting. The purpose of the present study was to evaluate the association between the clinical course, obstetric complications and birth outcome in pregnant women with HG, and to determine the epidemiological characteristics of these women.

Objective: To evaluate maternal characteristics and pregnancy outcomes among women with hyperemesis gravidarum.

Method:  A total of 75(case)i.e. pregnancy with hyperemesis and 75(control) i.e. women with normal pregnancy without hyperemesis were studied. A case control study was conducted in Dhulikhel hospital in Nepal. It was a hospital-based study and the data were collected during 10th August 2022 to 1^st May 2023. The pre-structured questionnaire was used for history taking and examination of all participants.

Result: This study identified that maternal and fetal complications were higher in women with hyperemesis gravidarum. The maternal complications like Hypertensive Disorders (OR 2.49, 95%CI :1.04-5.94, P=0.031), Anemia (OR 2.07, 95%CI:1.07-4.02, P=0.031), Preterm Labor (OR 2.28, 95%CI:1.15-4.52, P=0.018), PPH (OR 2.65, 95%CI:1.07-6.54, P=0.036) and P-v leaking (OR 0.89, 95%CI: 0.36-2.25) were associated more with the pregnancies complicated with hyperemesis gravidarum. The fetal complications like low birth weight (OR 2.42, 95%CI :1.07-5.43, P=0.03), NICU admission (OR 3.27, 95%CI:1.48-7.25, P=0.003), low APGAR score (OR 2.32, 95%CI:1.05-5.11, P=0.034) and Neonatal Death (OR 3.72, 95%CI:1.15-12.01, P=0.04) were associated more with pregnancies complicated with hyperemesis gravidarum.

Conclusion: The women with hyperemesis gravidarum were found to have increased risk of maternal and fetal complications. Thus, timely identification and management of hyperemesis is recommended to prevent long term complications.