Hyperemesis Gravidarum Pathophysiology
Some claimed that, the feeling of nausea is the result of increased estrogen levels, therefore this complaint occurred in the first trimester.
Psychological influence of estrogen is unclear, possibly derived from the central nervous system or due to reduced gastric emptying. Adjustment occurs in most pregnant women, though nausea and vomiting can last for months.
Hyperemesis garavidarum which is a complication of nausea and vomiting in early pregnancy, when persistent can lead to dehydration and electrolyte imbalance with hipokloremik alkalosis. Unclear why this phenomenon occurs only at a fraction of women, but psychological factors are the main factors, in addition to hormonal factors. Clearly the woman before pregnancy had suffered with symptoms of spastic stomach does not like to eat and nausea, will experience severe emesis gravidarum. Hyperemesis gravidarum can lead to carbohydrate and fat reserves used up for energy purposes. Because fat oxidation is not perfect, there ketosis with acetone-acetic acid accumulation, butirik hydroxy acid and acetone in the blood. Shortage of drinking liquids and fluid loss due to vomiting can cause dehydration, sehmgga ekstraselurer fluid and plasma is reduced. Sodium and Chlorides blood falls, as well as urine Chloride. Besides dehydration caused hemoconcentration, so that blood flow to tissues is reduced. This causes the amount of nutrients and oxygen to the tissues is reduced as well and tertimbunlah toxic metabolic substances. Potassium deficiency as a result of vomiting and increased excretion via the kidneys, increasing the frequency of vomiting is more, it can damage the liver and there was a vicious circle difficult to break.