Almost every pregnant woman experiences some nausea and vomiting in pregnancy. In most of these cases the symptoms do not result in serious complications, but excessive vomiting in pregnancy is a different condition that if not properly managed can have serious consequences for the pregnant woman and her developing fetus.
What is hyperemesis gravidarum?
The medical term for severe morning sickness is “hyperemesis gravidarum (HG)” (which means “excessive vomiting during pregnancy”). Hyperemesis gravidarum is much worse than the normal nausea and vomiting in pregnancy (“morning sickness”). Signs and symptoms of HG include: prolonged and severe nausea and vomiting. Some women report being sick up to 50 times a day, have severe weight loss, and the condition is associated with electrolyte disturbance.
Morning sickness and hyperemesis gravidarum are very different conditions. They have different complications and side effects for pregnant women. It is important to distinguish between these two conditions to properly treat symptoms.
HG often begins earlier in the pregnancy, between weeks 4 and 5, and lasts longer than the symptoms of morning sickness. Hyperemesis gravidarum can be extremely debilitating and cause fatigue that lasts for weeks or months.
Unlike regular pregnancy sickness, HG may not get better by 14 weeks. It may not clear up completely until the baby is born, although some symptoms may improve at around 20 weeks.
What causes hyperemesis gravidarum?
It is believed that hyperemesis gravidarum is caused by a rise in hormone levels; however, the absolute cause is still unknown.
What are some of the symptoms of hyperemesis gravidarum?
Signs and symptoms will vary from one pregnant woman to another but some of the most common symptoms of this disorder include the following:
• vomiting more than three or four times per day
• becoming dehydrated
• feeling light-headed or dizzy
• weight loss-losing more than 10 pounds or 5 percent of your body weight due to vomiting
• feeling nearly constant nausea
• ketosis – a serious condition that results in the build-up of acidic chemicals in the blood and urine. Ketones are produced when your body breaks down fat, rather than glucose, for energy
• low blood pressure (hypotension) when standing
Who gets hyperemesis gravidarum?
While any woman can get this disorder some women are more at risk than others. Some factors that could increase your risk of getting HG are:
• having a history of HG
• being pregnant with more than one baby
• being overweight
• being a first-time mother
Treatment
Treatment for HG depends on the severity of the symptoms. Your doctor may recommend natural nausea prevention methods such as vitamin B-6 or ginger. He or she might recommend eating smaller, more frequent, meals and dry foods such as crackers. You should drink plenty of fluids like fresh coconut water to stay hydrated.
Severe cases may require hospitalization. Pregnant women who are unable to keep fluids or food down due to constant vomiting will need to get them intravenously, or through an IV. Medication is necessary when vomiting is a threat to the mother or child. There are a few anti-nausea drugs available but these must be used with caution. Taking medication while pregnant can cause potential health problems for your baby but, in severe cases of HG, maternal dehydration is a more concerning problem and medications must be used. Talk to your doctor about the risks associated with any method of treatment.
Conclusion
Hyperemesis garvidarum, also referred to as excessive nausea and vomiting in pregnancy, is a serious disorder that requires expert treatment if severe consequences are to be avoided. The exact cause is not known at present, but with good management many women with this disorder go on to have a successful pregnancy. If you have severe nausea and vomiting in pregnancy seek medical attention.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG, is an Obstetrician/Gynaecologist and Family Doctor who has over thirty-two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
