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Makmur S
Hiperemesis Gravidarum
Defenisi: Defenisi: Mual dan muntah yang hebat pd kehamilan muda mengakibatkan pekerjaan sehari-hari terganggu dan seharikeadaan umum memburuk. memburuk. Etiologi: Etiologi: belum diketahui secara pasti
FAKTOR PREDISPOSISI
Steps of Vomiting
Patologi.
Pada bedah mayat:
1. 2. 3.
mamiliria, ventrikel III dan IV, encefalopati wernickel. wernickel 4. Ginjal: Pucat dan deg.Lemak pd tubuli kontorti. kontorti
Hati: degenerasii llemak, nekrosis. H ti d k k i Jantung: Atrofi, perdarahan subendokardial. Otak: bercak perdarahan pd corpora
Patofisiologi
Pembakaran fat yg terus menerus oksidasi tak sempurna ketosis. Mual dan muntah M ld t h dehidrasi hemokonsentrasi zat toksik memenuhi jaringan. Muntah hipokalemia p Muntah hipokalemiaperut p gembung dan kerusakan hati.
Tahap III. Muntah berhenti kesadaran menurun ( somnolent - coma ), nadi menurun, ikt ikterus, temp naik, TD t ik menurun, Komplikasi yang fatal ggn SSP, encepalofati Wernickle ( nistagmus dan diplopia ), ggn mental.
Pengobatan.
1. 1 2. 3. 4. 5. 5 6. 6
Isolasi. Isolasi Terapi Psikologik. Cairan Parenteral. Lab: hb, Urea darah, kgd, elektrolit dan , , g , liver function test. Insulin, asam amino essensial dan vitamin. Makanan peroral dgn sedikit cairan cairan.
Diff. Diagnosa:
1. 1 2. 3. 4. 5.
Diet Modifications:
Eat smaller, more frequent meals. Avoid fatty, creamy foods which slow down gastric emptying. Eat mainly carbohydrates which are bland such as potatoes, pasta, rice, or soups including these. Drink sports drink or bouillon in small sips for a total of 1- 1 5 L/ day to 1- 1.5 prevent dehydration. They tend to be better tolerated than water. Introduce crackers and peanut butter, or cheese in small amounts as tolerated for protein. Next, small amounts of baked chicken or fish can be introduced as there are digested more easily.
So you tell her to try these and come back in about a week if not improving.
INTRODUCTION
HG, defined as persistent vomiting that leads to weight loss greater than 5% of prepre-pregnancy weight, with associated electrolyte i b l l t l t imbalance and k t d ketonuria, i occurs in about 1% of pregnancies. Although NVP may be classified as mild, moderate, severe, moderate or severe, the severity of nausea or vomiting may not adequately reflect the distress it causes causes.
VOMITING PATHWAYS
Ipecac syrup
3. Faktor Organik Masuknya villi chorialis dalam sirkulasi ibu resistensi ibu menurun menurun.