About 50-90% of women who have been pregnant have said they have suffered some form of morning sickness during their pregnancy.  Morning sickness is when you feel nauseous and sometimes vomit during the first trimester.  Usually after your first trimester the morning sickness lessens. 

Less than 3% of women who are pregnant suffer from Hyperemesis gravidarum.  This is severe and persistent nausea and vomiting during pregnancy.  The vomiting is so severe that it can lead to other complications during pregnancy.  It can start between the 4th and 6th week of pregnancy and is usually at its worst from the 9-13th week.  It usually goes away after the first trimester, but some people have Hyperemesis gravidarum till term. 

Hyperemesis gravidarum is said to be caused by the rise in HCG hormone levels in the body during pregnancy.  Carrying multiples can also put you at higher risk, or having a hydatidiform mole, which is abnormal tissue growth and not a real pregnancy.

 

Symptoms  

Symptoms are severe vomiting and nausea that start affecting your quality of life. Completing normal daily activities becomes impossible.  Vomiting may happen 3-4 times a day.  Vomiting can cause you to lose more than 10lbs. 

You may feel dizzy and lightheaded.  Dehydration can be a concern.  Saliva making increases, which can also make you feel more nauseous.  You may also have constipation.  

 

Complications

The main complication that can be of concern with Hyperemesis gravidarum is dehydration.  If you are unable to eat or drink it could be harmful to you and your baby.  Kidney function may start failing along with dehydration due to lack of urine output.  Some people may lose 5% of their body weight.  Your body’s electrolytes may become unbalanced. 

Low sodium and potassium levels can cause blood pressure changes, dizziness, and weakness.  Muscle weakness may occur due to malnutrition or bed rest.  

 

Diagnosis

If you suspect you have Hyperemesis gravidarum you will want to talk to your doctor right away.  They will do a physical exam on you, and get all your signs and symptoms.  They will see if you have suffered from this condition in any previous pregnancies.  Having Hyperemesis gravidarum during one pregnancy puts you at higher risk for future pregnancies. 

They will also run tests to check your complete blood count, electrolyte levels, urine ketones, and do a weight check.  They may see that your blood pressure is low and your pulse is high. 

Your doctor may want to do a pregnancy ultrasound to check for carrying multiples or a hydatidiform mole.  Other tests may be done to check for liver and GI problems and rule other causes of the nausea and vomiting.  

 

Treatment

There is no one treatment for Hyperemesis gravidarum.  It usually goes away on its own after the first trimester.  If you become dehydrated you may need to be admitted into the hospital to be given IV fluids.  If your body isn’t getting enough nutrients, you may have an IV put in for nutrients, or a feeding tube put in.  In severe cases an IV with nutrients may be in place for the entire pregnancy to make sure that the baby is getting enough nutrients. 

Some anti nausea meds may work to help you be able to eat and drink more often.  At home it will be important for you to avoid triggers that make you feel nauseous.  Triggers could be certain noises, smells, bright lights, flickering lights, toothpaste, too tight clothing, riding in a car, or taking showers.  Identifying your triggers and what causes you to become overly nauseous can help. 

When you are able to eat and drink, eat small meals frequently.  Eat what sounds good to you, or try to stick to bland foods such as crackers, rice or potatoes.  Bananas are also a good food to eat when feeling nauseous. 

Increase fluids when you don’t feel too nauseous.  Seltzers, and ginger ale can be good. 

Ginger supplements can also help.  Vitamin B6 has been shown to be helpful to decrease nausea during pregnancy. 

Waiting to take your iron supplement until you don’t feel nauseous can also help lower nausea. 

 

Takeaway 

Hyperemesis is not fatal to you or your baby.  It can make the first trimester extremely difficult especially when your quality of life is being affected.  You may need to have a short stay in the hospital if you lose too much weight, or become dehydrated to make sure that you and the baby are getting the nutrients you both need. 

Most of the time Hyperemesis gravidarum lessens after the first trimester and only affects less than 3% of all pregnancies.  You are at a higher risk if you have had this condition before or you are carrying multiples.  

 

 

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