CASE REPORT: HYPEREMESIS GRAVIDARUM IN A HIGH-RISK PREGNANCY FOLLOWING A LONG INTERPREGNANCY INTERVAL (≥10 YEARS)
Abstract
Hyperemesis gravidarum is excessive nausea and vomiting during pregnancy that may lead to fluid and nutritional imbalance and interfere with daily activities. The literature suggests that hyperemesis gravidarum occurs more frequently in primigravida than multigravida women. However, this case report describes hyperemesis gravidarum in a multigravida woman with a high-risk pregnancy due to secondary elderly primigravida status with an interpregnancy interval of more than 10 years. This final project employed a case report method involving Mrs. N, a 27-year-old G2P10001 woman at 11 weeks of gestation diagnosed with grade I hyperemesis gravidarum. Midwifery care was provided using the SOAP approach, including assessment, data analysis, management, and evaluation. The interventions included ginger drink consumption twice daily, Pericardium 6 (PC6) acupressure, dietary management, psychological support, and collaborative pharmacological therapy. The assessment revealed that the patient experienced nausea and vomiting with every meal and drink, weakness, dizziness, weight loss from 71 kg to 68 kg, and a PUQE score of 14. Following continuous midwifery care, the frequency of nausea and vomiting decreased, as indicated by a reduction in the PUQE score to 3, improved appetite, weight gain to 70 kg, and the ability to resume daily activities. Ginger drink consumption and PC6 acupressure as non-pharmacological therapies contributed to reducing the frequency of nausea and vomiting, supported by pharmacological treatment and other comprehensive midwifery interventions. Comprehensive midwifery care showed positive outcomes in improving the patient's condition. Therefore, the management of hyperemesis gravidarum should be tailored to each patient's condition and needs through a comprehensive approach.Keywords
Hyperemesis gravidarum, High-risk pregnancy, Secondary elderly primigravida, Midwifery care
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