Understanding Hyperemesis: What Every Pregnant Woman Needs to Know

Pregnancy is a time of joy and excitement,   but for some women, it can be impacted by a Distressing condition known as hyperemesis gravidarum. This severe form of morning sickness can turn what should be a celebration of new life into a challenging and rarely, a dangerous experience. Let us look into what every expectant mother should know about hyperemesis in pregnancy.

What is Hyperemesis Gravidarum?

Hyperemesis gravidarum (HG) is a severe and persistent form of nausea and vomiting during pregnancy. The definition of hyperemesis gravidarum goes beyond typical morning sickness, characterised by extreme, persistent nausea and vomiting, dehydration, and weight loss   This condition can be so severe that it interferes with daily life and may require hospitalisation.

Difference Between Hyperemesis Gravidarum vs. Morning Sickness

While up to 7  of pregnant ladies have some form of morning sickness, hyperemesis gravidarum affects 1-3 in 100 Pregnant Women. The key differences include:

1. Severity: Morning sickness is uncomfortable but manageable, while HG is characterised by severe morning sickness.
2. Duration: Morning sickness typically subsides by the second trimester, whereas HG can last throughout pregnancy.
3. Impact: Morning sickness rarely leads to severe complications, but HG can cause dehydration, malnutrition, and electrolyte imbalances.

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Symptoms and Causes of Hyperemesis Gravidarum

The signs of hyperemesis gravidarum are hard to ignore. They include:

• Severe, persistent nausea
• Frequent vomiting (often more than 3-4 times a day)
• Weight loss
• Dehydration
• Dizziness and fainting
• Extreme fatigue
• Low blood pressure and rapid heart rate

The exact hyperemesis gravidarum causes are not fully understood, but several factors may contribute:

• Hormonal changes, particularly elevated levels of HCG (human chorionic gonadotropin)
• Genetic predisposition

Risk Factors for Developing Hyperemesis Gravidarum

While any pregnant woman can develop HG, certain hyperemesis gravidarum risk factors are:

• Previous history of HG
• Multiple pregnancies (twins, triplets, etc.)
• First pregnancy
• Family history of HG
• History of motion sickness or migraines

Being overweight or underweight before pregnancy

Prevention

Prevention of hyperemesis gravidarum is challenging since its exact cause is unknown. However, early recognition and treatment can help manage symptoms and prevent complications.

Potential Complications of Hyperemesis Gravidarum

If left untreated, HG can lead to serious complications for both mother and baby:

• Severe dehydration
• Electrolyte imbalances
• Nutritional deficiencies
• Wernicke’s encephalopathy (due to thiamine deficiency)
• Depression and anxiety
• Increased risk of preterm birth or low birth weight

Diagnosis of Hyperemesis Gravidarum

Diagnosis of hyperemesis gravidarum depends on a combination of hyperemesis gravidarum symptoms, physical examination, and laboratory tests. Your doctor may:

• Assess your symptoms and weight loss
• Check for signs of dehydration
• Perform blood tests to check blood electrolyte levels and liver function
• Conduct urine tests to check for ketones (a sign of dehydration)

Treatment Options for Hyperemesis Gravidarum

Hyperemesis treatment aims to manage symptoms and prevent complications. Options may include:

Conservative Measures:

Dietary Modifications: Eating small, frequent meals high in protein; avoiding trigger foods and odours; having snacks before getting out of bed

Lifestyle Changes: Getting adequate rest, avoiding stress 

Pharmacotherapy:

Prescription of anti-emetics

IV Fluid and Electrolyte Replacement:

• To correct dehydration and electrolyte imbalances
• May include thiamine supplementation to prevent Wernicke’s encephalopathy

Nutritional Support:

• Vitamin supplementation, especially thiamine, folic acid, vitamins K, D, and magnesium
• Parenteral nutrition in severe cases, unresponsive to other treatments

Other Medications:

• Acid-reducing medications or proton pump inhibitors for heartburn/reflux
• Corticosteroids (e.g. methylprednisolone) for refractory cases after the first trimester

Alternative Therapies:

• Acupuncture
• Hypnosis

Psychological Support:

Counselling to address the emotional impact of HG

Conclusion

Hyperemesis gravidarum is a severe condition that can turn the joy of pregnancy into a challenging ordeal. However, with proper understanding, early diagnosis, and appropriate treatment, most women with HG can navigate their pregnancy successfully, says Dr. Prathima Reddy. If you’re experiencing severe nausea and vomiting during pregnancy, don’t hesitate to reach out to your doctor. Remember, you’re not alone, and help is available.

Frequently Asked Questions

How common is hyperemesis gravidarum during pregnancy?

Hyperemesis gravidarum affects about 1-3 in 100 Pregnant Women, making it relatively rare compared to typical morning sickness.

In which stage of pregnancy is hyperemesis gravidarum most common?

HG typically begins in the first trimester,  . While it may improve for some women after the first trimester, others may experience symptoms throughout their pregnancy.

Is hyperemesis gravidarum considered a high-risk pregnancy?

While HG itself doesn’t necessarily make a pregnancy high-risk, the potential complications it can cause may necessitate closer monitoring. Each case is unique, and your doctor will assess your individual situation to determine the level of risk and care needed.