GRAVIDARUM
Deviana S. Riu
DEFINITION
Multiple pregnancy
Molahydatidiform
Linked with:
Weight loss
Dehydration
Acidosis
Alkalosis
Hypokalemia
Lab :
Light Hyperbilirubinemia
liver disfunction
ETIOLOGI
Hormon hCG
Other hormones
Progesteron ?
Estrogen :
HG is mainly found in women with high
estrogen conditions such as high BMI
Treatment with estrogen: effects of nausea
and vomiting
Estrogen causes peristaltic bowel and
gastric emptying slow resulting an
accumulation of fluid due to increased steroid
hormones.
pH changes cause gastrointestinal
helycobacter pylori infection, which is also
associated with symptoms of indigestion
Thyroid
hormone
Thyroid hormone receptors sensitive to hCG,
resulting in decreased TSH and free T3 and
T4 increased
Adrenal cortex
Low cortisol linked to HG
Response to treatment with therapeutic
corticosteroid
Leptin
Reduces appetite and works with cortisol,
thyroid hormone
Growth hormone and prolactin?
Immunology
GI tract
Degree 1
Continuous vomiting (vomiting> 3-4
times / day, and prevent the entry of food
or drink for 24 hours) which caused the
mother to be weak, no appetite, weight
loss (2-3 kg in 1-2 weeks), heartburn,
pulse increased to 100x permenit,
systolic blood pressure decreased, turgor
decreases and sunken eyes
Degree 2
Patients seem more vulnerable and do
not care about the surroundings, small
and rapid pulse, temperature sometimes
rises and eyes slightly yellow. Weight
loss and the eyes become sunken, blood
pressure falls, blood coagulation, urine
decreased, and constipation. In the
breath may smell of acetone
Degree 3
General state of more severe, stop vomiting,
decreased consciousness to coma, small and
rapid pulse, temperature increases, and blood
pressure down. In the newborn baby may
occur with symptoms of Wernicke's
encephalopathy: nistagmus, double vision,
and mental changes. This situation is due to
lack of nutrients, including vitamin B complex.
If Icterus means existing liver disorders
EXAMINATION
Urine
ketones, bilirubinuria
Blood
blood electrolytes, urea, creatinine,
glucose, liver function, thyroid function
USG
gestation, a multiple gestation, fetal
abnormalities , molar pregnancy.
MANAGEMENT
KOMPLIKASI
Epistaksis
Wernicke encephalopathy (blindness,
seizures and coma)
DIFFERENTIAL DIAGNOSIS
Gastroenteritis
Cholecystitis
Pancreatitis
Hepatitis
Ulcer peptik
Acute fatty liver
Thank You