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Overview of Hyperemesis Gravidarum

written by: kristenrosenthal • edited by: Leigh A. Zaykoski • updated: 6/30/2009

More than half of pregnant women experience morning sickness during their first trimester. Unfortunately, some women experience extreme nausea and vomiting that makes eating and keeping food down impossible. This extreme morning sickness, called hyperemesis gravidarum, makes pregnant life difficult.

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    As many pregnant women (and their partners) know, the normal nausea and vomiting associated with morning sickness can be one of the most difficult aspects of pregnancy. Now imagine nausea and vomiting so severe you cannot eat or drink and you vomit four or more times a day.

    Hyperemesis gravidarum is a condition during pregnancy characterized by excessive nausea, vomiting, weight-loss, dehydration, and electrolyte disturbances. In some cases, malnutrition and related complications can also occur. These complications can compromise both the health of the expecting mother and her baby. As an expectant mother, it is very important to discuss any concerns with your doctor if you think you may have this condition. Early treatment is very important in keeping you and your baby healthy!

    Unfortunately, the exact cause of extreme morning sickness during pregnancy is not know at this time. Some studies have suggested that rapidly increasing hormone levels (hCG and estrogen) may play a role in this disease. In addition, it may also have a genetic component as sisters and daughters of women who have had hyperemesis gravidarum also have a higher incidence. Women with various pre-existing conditions, including motion sickness, migraines, diabetes, and gastrointestinal disorders, may have an increased risk of developing extreme morning sickness. While research into the causes of this disease are still ongoing, it is important to note that this is a physiological condition and not psychological, as had been presumed in the past.

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    Signs and Symptoms of Hyperemesis Gravidarum

    • Severe nausea and vomiting
    • Food adversions
    • Weight loss
    • Dehydration (decreased urination, increased thirst)
    • Headaches
    • Confusion
    • Weakness and/or Fainting
    • Difficulty with daily activities
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    Treatment of Hyperemesis Gravidarum

    For mild cases of hyperemesis gravidarum, lots of rest, dietary changes, and over-the-counter medicines (like antacids) may be all that is needed to combat symptoms. For more moderate to severe cases of extreme morning sickness, more aggressive measures need to be taken. In these cases, hospitalization is required to stabilize and control the symptoms as well as to give fluids and nutrients that have already been depleted by multiple episodes of vomiting.

    During hospitalization, patients are given intravenous fluids to re-hydrate and restore electrolyte levels. It may also be necessary to give nutrients to the patient through the IV line (called parenteral nutrition). For severe cases, medicine will also be administered to control the nausea. Normally, vitamin B6 and doxylamine (the active ingredient in over-the-counter sleep medicine) are tried first and if these medications are ineffective, other more potent anti-nausea medications may be recommended.

    Unfortunately, as with most medications, the effects of these drugs on developing babies have not been extensively studied though most are considered relatively safe. For more information on the various drugs used to control extreme nausea during pregnancy, eMedicine has a good list of the available options (as linked in the References section of this article).

    Once extreme nausea and vomiting is under control, IV lines and anti-nausea medications may be able to be slowly weaned and then discontinued. At this time, symptoms can then be managed by various other means. These measures include plenty of rest; eating small, frequent meals; changes in diet; avoidance of trigger foods and/or smells; and the use of alternative medicines such as ginger or stimulation of pressure points (like the pressure point wristbands used for motion sickness). It is also important to have a good emotional support system during such a trying disease, as you are both physically and mentally depleted by such a complete and difficult change in your body.

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    The information in this article should not be considered medical advice. Always check with your physician before taking any products or following any advice you have read on Brighthub.com.