Comprehensive Midwifery Care Improves Clinical and Nutritional Outcomes in a Primigravida Woman with Chronic Energy Deficiency Complicated by Hyperemesis Gravidarum

Septi Mustika Ningrum, Triana Septianti Purwanto, Sunarto Sunarto, Astin Nur Hanifah

Abstract


Chronic Energy Deficiency (CED) and Hyperemesis Gravidarum (HG) are common conditions that may coexist during pregnancy and increase the risk of adverse maternal and fetal outcomes, particularly among primigravida women. Persistent nausea and vomiting may worsen pre-existing nutritional deficiencies, making comprehensive midwifery care essential. This case report aimed to describe the implementation of comprehensive midwifery care for a primigravida woman with CED complicated by HG. A case report design was conducted on a 24-year-old primigravida at 20 weeks and 2 days of gestation with concurrent CED and HG. Midwifery care was provided at Taji Community Health Center, Magetan Regency, Indonesia, from March 30 to April 13, 2026, through one initial assessment and two home visits. Care was implemented using the Varney Midwifery Management Approach and documented using the SOAP format. Interventions included pharmacological antiemetic therapy, dietary and fluid counseling, Multiple Micronutrient Supplement (MMS) supplementation, health education, and continuous monitoring using the Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) score. Progressive clinical improvement was observed throughout the follow-up period. The PUQE score decreased from 13 (severe) at baseline to 10 at the first follow-up and 4 at the final visit. Maternal body weight increased from 48.0 kg to 48.4 kg and subsequently to 49.1 kg. The patient experienced complete resolution of nausea and vomiting, improved oral intake, resumed normal daily activities, and demonstrated good adherence to both pharmacological and non-pharmacological interventions. However, CED had not been completely resolved by the end of follow-up. Comprehensive midwifery care combining pharmacological treatment, nutritional counseling, MMS supplementation, health education, and continuous monitoring effectively improved clinical symptoms and maternal nutritional status in a primigravida woman with CED complicated by HG. Ongoing antenatal monitoring remains necessary until delivery to achieve optimal maternal nutritional recovery and prevent maternal and perinatal complications.
Keywords: Chronic Energy Deficiency, Hyperemesis Gravidarum, Comprehensive Midwifery Care.

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DOI: https://doi.org/10.33846/%25x

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