Vomiting in pregnancy is very common. It is so common that it is often used as one of the signs of pregnancy. For most women, this improves or stops completely by around weeks 16 to 20 of pregnancy. A few women have very severe vomiting in pregnancy which can be life threatening and often requires hospitalisation. This excessive nausea and vomiting are known as hyperemesis gravidarum (HG).
What causes hyperemesis gravidarum?
The condition might be caused by rapidly rising serum levels of hormones such as HCG (human chorionic gonadotropin) and oestrogen. Extreme nausea and vomiting during pregnancy might indicate a multiple pregnancy (you are carrying more than one baby) or hydatidiform mole (abnormal tissue growth that is not a true pregnancy).
What are the symptoms of hyperemesis gravidarum?
Hyperemesis gravidarum usually occurs during the first trimester of pregnancy (early pregnancy). The woman might have hyperemesis gravidarum if she is pregnant and vomits more than three to four times a day so that she might lose more than 10 pounds. She might also experience dizziness and feel lightheaded. The excessive vomiting might lead to dehydration.
How is hyperemesis gravidarum treated?
There are no known ways to completely prevent hyperemesis gravidarum. Avoiding triggers such as strong odours, excessive fatigue, spicy foods and foods high in sugar may help. Management and treatment will vary depending on the severity of symptoms. All cases should be managed by an experienced obstetrician/gynaecologist. The use of ginger and vitamin B6 are recommended for mild cases. Small frequent meals are encouraged as well as the use of dry foods such as crackers. It is important for a pregnant woman to maintain her fluid intake. Intravenous (IV) fluids might be needed if a woman continues to vomit throughout pregnancy. In severe cases, the woman might require hospitalisation and given IV fluids. IV fluids might be discontinued when a woman is able to take in fluids by mouth.
The most severe cases of hyperemesis gravidarum might require that complex, balanced solutions of nutrients be given through an IV throughout pregnancy. This is called total parenteral nutrition (TPN).
Various medications to prevent nausea are often used when vomiting is persistent and poses possible risks to the mother or baby. If a woman cannot take medicines by mouth, the drugs might be administered through an IV or a suppository.
Conclusion
Vomiting in pregnancy is very common. For most women, this improves or stops completely by around weeks 16 to 20 of their pregnancy. Some pregnant women experience very bad nausea and vomiting. They might be vomiting many times a day and be unable to keep food or drink down – which can impact on their daily life. This excessive nausea and vomiting are known as hyperemesis gravidarum (HG), and often need hospital treatment. If you are pregnant and vomiting frequently, and cannot keep food down, tell your midwife or obstetrician/gynaecologist, or contact the hospital as soon as possible. There is a risk you may become dehydrated, and your midwife or doctor can make sure you get the right treatment.
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 is ongoing, it is possible that new findings may supersede some data presented.
Dr. Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty eight years in clinical practice. Dr. Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
