Nausea and vomiting are the most common symptoms of pregnancy. One to three in every 100 women who become pregnant in the world may experience severe nausea and vomiting called hyperemesis gravidarum.
What happens in Hyperemesis Gravidarum?
Morning sickness in pregnancy, which can occur at any other time but is usually more severe in the morning, often has mild symptoms and resolves after a few minutes. However, it may recur one or two hours later.
Pregnancy nausea usually lasts about one to four hours, and some women experience only this condition and are less likely to vomit. Pregnancy nausea and vomiting usually begin before the ninth week and disappear around the twelfth to sixteenth week of pregnancy.
However, it may continue in some women until the end of pregnancy. Still, hyperemesis gravidarum is a condition in which nausea is so severe that the mother becomes malnourished and dehydrated due to the intense excretion of water and fluids.
Symptoms
Symptoms of HG begin in the first six weeks of pregnancy. Nausea often does not go away. They may also be unable to perform their normal daily activities. This condition can be debilitating and cause fatigue that lasts for weeks or months; it often needs to be hospitalized to replenish lost fluids. Symptoms of Hyperemesis Gravidarum include:
- Loss of appetite
- Vomiting more than three or four times per day
- Losing weight
- Malnutrition, electrolyte imbalance, and low levels of minerals
- Feeling nearly constant nausea
- Becoming dehydrated
- Feeling light-headed or dizzy
- Rising pulse rate and a rapid heartbeat
- Unusual breath odor
- Headaches
Causes
The exact cause of Hyperemesis Gravidarum is unknown, but it is most likely to increase human chorionic gonadotropin (hCG), a hormone the placenta produces during pregnancy. Your body produces large amounts of this hormone rapidly in early pregnancy. These levels can increase during your pregnancy. Other causes include:
- Increase in blood thyroxine levels
- Multiple pregnancies
- Abnormal tissue growth in the uterus
- Abnormalities of peristalsis
- Liver abnormalities
- Inner ear problems
- Infection with Helicobacter pylori
- Deficiency of the nutrients zinc and pyridoxine
Risk factors
Some factors can increase the risk of Hyperemesis Gravidarum. These factors include:
- Being overweight
- Being a first-time mother
- Have migraines outside of pregnancy
- Experience vomiting nausea or vomiting when they are not pregnant
- Having multiple pregnancies
- Take medications containing estrogen
Diagnosis
A complete clinical evaluation, accurate patient history, and identification of characteristic symptoms such as persistent and severe nausea and vomiting, dehydration, and weight loss are evaluated. Doctors determine the frequency of nausea and vomiting and how much it affects a woman’s daily life.
A standard physical examination is required for further diagnosis. The obstetrician looks for common symptoms of HG, such as abnormal blood pressure or rapid pulse.
Blood and urine samples may also be needed to check for signs of dehydration. Your doctor may perform other tests to rule out gastrointestinal problems that cause nausea or vomiting. An ultrasound may need to find out if you are pregnant with twins or have a problem.
Treatment
Treatment depends on the severity of the symptoms and the treatment’s effectiveness in reducing the severity of the symptoms. Up to 5% of women with this disease must go to the hospital.
Lifestyle changes
Try to eat a smaller amount of food but more often and increase fluid intake as much as possible. If hot foods cause nausea, try cold foods. Get enough sleep, and try to manage your stress. Consumption of ginger 1 to 1.5 grams daily in small doses may help reduce symptoms. You can take it in tea, licorice, or supplements. Pyridoxine, also known as vitamin B6, is often prescribed for nausea during pregnancy. Typical doses are 10 to 25 mg, three times a day.
Medicines
Your doctor may prescribe one or more medications to reduce symptoms you can take by mouth, suppository, or shot. Antacids and steroid medication can also be useful. The doctor ensures that any medication prescribes is not harmful to your baby.
Mental health support
Chronic vomiting can be very anxious and stressful, especially if a woman has to stay in the hospital. Support and therapy groups can help to manage this chronic stress.
Rest
Resting may reduce vomiting and stress.
Prevention
Doctors do not know what causes hyperemesis gravidarum, and there is little evidence that any specific solution can prevent it. But solutions such as: Eating protein-rich meals every two hours to increase your strength and following a healthy diet with plenty of fluids can help. Women who experience hyperemesis gravidarum in one pregnancy are likelier to experience it in another.
Complications
The main risks for women with hyperemesis gravidarum are dehydration and electrolyte imbalance. They are also at higher risk for preterm birth and preeclampsia. If left untreated, long-term side effects may occur if the mother cannot gain enough weight in the second half of pregnancy and the baby suffers malnourished. Without treatment, it can cause severe complications for the mother and the developing fetus. These include the following:
- Wernicke’s encephalopathy
- Electrolyte imbalances
- Blood clots because of severe dehydration
- Damage to the teeth
- Damage to the placenta
- Preterm labor
- Low birth weight
- Ruptured esophagus
When to see a doctor
Nausea and vomiting are common in early pregnancy. However, when these symptoms interfere with daily functioning, it may be a sign of hyperemesis gravidarum. If pregnant women have the following symptoms, they should see an obstetrician:
- Severe nausea is accompanied by vomiting at least once a day
- Vomiting and nausea do not improve in the second trimester
- Excessive vomiting causes them not to gain weight or lose weight
- Cannot stand any food
- Feeling weak, shaky, confused, and dehydrated
Practical tips
Many women experience nausea during pregnancy, but some experience more severe symptoms. Here are some tips about hyperemesis gravidarum that you may not know them.
Baby is probably not at risk
Hyperemesis Gravidarum, which is usually very severe in the first trimester of pregnancy, is the greatest concern in the lack of water and electrolytes. But this is a concern for the mother, not the baby because babies do not need a lot of calories at this stage and get everything they need directly from their mother.
Eating less does not mean you vomit less
In the case of hyperemesis gravidarum, the more dehydrated the mother is, the more nausea she has, and the more likely she is to vomit. So it is a misconception that if I eat less, I have less nausea and vomiting.
HG can be a good thing in terms of hormones
Women with hyperemesis gravidarum in the early stages of pregnancy are less likely to have an abortion due to high hormone levels. It is usually associated with high levels of pregnancy hormones, which indicates a complete pregnancy. Of course, if not controlled, there is a possibility of abortion.
Be sure to get help from those around you
Pregnant mothers who suffer from this disease should inform those around them as much as possible, ask for their help, and accept friendly offers to help them.
Remind yourself that it is not forever
Hyperemesis Gravidarum is annoying, but remind yourself daily that this period is over, and all the states of this disease disappear when you hug your child.
Some foods can help
The BRATT diet (bananas, rice, potatoes, toast, and tea) is low in fat and easy to digest, so you may be able to tolerate it more and try to use protein sources in all meals. Eat the foods you like. Foods that make you less nauseous by eating them.
The bottom line
Finally, Hyperemesis Gravidarum is a severe type of vomiting during pregnancy, an annoying disease that requires several treatments together to reduce its symptoms and be patient during this time.
Suppose pregnant women in Los Angeles have a problem with Hyperemesis gravidarum. In that case, Dr. Arjang Naim is aware of this and can help solve the problem so that Pregnant mothers have a more comfortable pregnancy.
Additional questions
- What should an overweight woman do during pregnancy?
Eat a balanced diet rich in whole grains, vegetables, fruits, low-fat dairy, and lean protein.
- What are the early signs of preterm labor?
- Change in vaginal discharge or more vaginal discharge than usual
- Pressure in the pelvis or lower belly
- Constant low, dull backache
- Belly cramps with or without diarrhea
- Regular or frequent contractions that make the belly tighten like a fist
- Water breaks
- How many kilograms is the low birth weight?
Birth weight of fewer than 5 pounds, 8 ounces (2.5 kg) is called low birth weight. Babies weighing less than 3 pounds, 4 ounces (1.5 kg) at birth, are considered very low birth weight.
- Do nausea and vomiting mean a healthy pregnancy?
During pregnancy, mild to moderate nausea and vomiting is usually not harmful to the mother and fetus. However, it can become a problem if the mother cannot keep food or fluids down, becomes dehydrated, and loses weight.
5. What fruit is good for morning sickness?
Researchers have found that inhaling aromatherapy with a lemon scent reduces nausea in pregnant women. In moderation, lemon, and other citrus fruits are safe for mothers and babies during pregnancy.
References
https://my.clevelandclinic.org/health/diseases/12232-hyperemesis-gravidarum
https://www.healthline.com/health/hyperemesis-gravidarum
https://kidshealth.org/en/parents/hyperemesis-gravidarum.html
https://www.webmd.com/baby/what-is-hyperemesis-gravidarum
https://www.health.nsw.gov.au/kidsfamilies/MCFhealth/Pages/hyperemesis-gravidarum.aspx
https://www.everydayhealth.com/hyperemesis-gravidarum/guide/