Hyperemesis Gravidarum

How Can I Distinguish Hyperemesis Gravidarum From Normal Morning Sickness?

Morning sickness and hyperemesis gravidarum are not at all similar. Complications and side effects are entirely different in both cases. Differentiating these two conditions are significant for the proper treatment.

The following chart will help you to tell apart the hyperemesis gravidarum from morning sickness.

What Pregnancy Complications Can Arise Due To Hyperemesis Gravidarum?

The impact of the complications of hyperemesis gravidarum during pregnancy depends on its severity. Severe and uncontrollable vomiting can lead to:

• Significant weight loss
• Severe dehydration
• Decreased urination which can cause urinary tract infection
• Constant vomiting can cause bleeding in the esophagus
• The psychological effect of hyperemesis gravidarum is that it may cause anxiety and depression, which may continue even after delivery

What Causes Hyperemesis Gravidarum?

The causes of hyperemesis gravidarum are still unknown. Most of the studies blame the rise in hormone levels on hyperemesis gravidarum. The major hormone that cause hyperemesis gravidarum is human chorionic gonadotropin (HCG). HCG is discharged from the placenta during pregnancy.

Among the women with hyperemesis gravidarum, the level of HCG doubles every two to three days. When the level of this hormone rises at this rate rapidly during the pregnancy, surely the outcome will be uncontrollable nausea and vomiting (severity also increases).

Am I At A Risk For Hyperemesis Gravidarum?

There are some factors that increase the chances of hyperemesis gravidarum:

• Women with trophoblastic disease (abnormal growth of cells inside the uterus) are found to be more prone to hyperemesis gravidarum.
• Hydatidiform mole: It is a rare growth that happens during the beginning of pregnancy inside the womb. It is a kind of gestational trophoblastic disease.
• Women bearing multiple pregnancies.
• Obesity or overweight of the mother during pregnancy.
• If the woman already has a history of hyperemesis gravidarum, or it runs in the maternal family.
• A history of travel sickness and migraines can also trigger HG during pregnancy.
• You are expecting a girl child and this is your first baby.

What Are The Symptoms Of Hyperemesis Gravidarum?

The signs of hyperemesis gravidarum are:

• Severe and uncontrollable nausea (nearly constant) and vomiting during pregnancy.
• The decline in the urinating frequency and quantity.
• Aversion towards food, resulting in considerable pregnancy weight loss.
• Feeling dizzy and very weak.
• Low blood pressure and salivating more than normal.
• Losing the elasticity of the skin.
• Fainting, headaches, and a rapid heart rate.
• Feeling depressed, confused, and stressed all the time.

How Is Hyperemesis Gravidarum Diagnosed?

When you complain about extreme tiredness, vomiting more frequently and queasiness, your doctor will look for abnormally low blood pressure and fast heart rate. These are the common signs of hyperemesis gravidarum. The blood and urine test reveals the presence of human chorionic gonadotropin (HCG), signs of dehydration, etc. An ultrasound can reveal if there is a mass in the womb due to trophoblastic disease.

How Can Hyperemesis Gravidarum Be Treated?

As in the case of most health conditions, the doctor treats hyperemesis gravidarum according to the severity of the symptoms [2]. The medical treatment includes:

• In the severe case of dehydration, the major aftereffects of hyperemesis gravidarum, the patient needs hospital admission, and the doctor induces fluids through IV. This will ensure the optimum level of electrolytes, nutrients, and hydration
• As the patient is unable to take the food, it is easy for the baby and mother to get affected fast, as both can deprive of essential nutrition. So after admission to the hospital, the medical team will give extra nutrients either through the IV or in most severe cases through a tube placed on the stomach
• Anti-nausea medicines help in some cases and are generally they are induced through the IV as excessive vomiting can be harmful to the mother or child or both

What Measures Can Be Taken At Home To Reduce The Symptoms Of Hyperemesis Gravidarum?

Along with medical treatment, or if, the symptoms are moderate, some measures can be taken at home that aid in treating hyperemesis gravidarum.

Avoid The Triggers

If you notice certain things trigger nausea and vomiting, avoid those things at any cost. Some of the factors that trigger nausea and vomiting are:

• Smells: All the strong smells, especially, the smell of certain perfumes, toothpaste, bathing items, and grooming items are found to trigger vomiting and nausea
• Tight-fitting clothes: Tight-fitting clothes can apply pressure on the stomach, which can trigger vomiting and nausea
• Riding in a vehicle: A car ride can trigger the sensation of vomiting and nausea (motion sickness)

Drink And Eat Generously

Take the upper hand in situations you feel less nauseous to eat well and drink well. It is better to take frequent small portions of the meal. Try a ginger ale or other drinks that appeal to you plenty to stay well hydrated whenever you feel better.

Will Hyperemesis Gravidarum Harm My Baby?

Not really. HG can make you feel sore, tired, exhausted, and depressed but it is unlikely to affect your baby’s development. Infants of mothers with hyperemesis have lower birth weights and the mothers are more likely to have infants that are small for gestational age [3]. Do not worry too much. Your baby will take up the necessary nutrition from your body reserves.

You can then catch up on nutrition later. Mostly, when treated properly HG does not impact the baby, but if left untreated, there is a chance that your baby will be smaller than average at birth. This is, however, quite rare.

Are The Medications Of Nausea And Vomiting Safe During Pregnancy?

It is true that taking medicines during pregnancy can cause mild to severe health problems for the child in the womb. But maternal dehydration is the more significant problem and when your doctor weighs the benefits and risks of the medicines and suggests taking the medicines, go ahead with your doctor’s decision. Anti-sickness medicines are generally safe and have no harmful effects on the baby.

FAQ’s

1. When Does Hyperemesis Gravidarum Stop?

Hyperemesis Gravidarum typically occurs between the fourth and sixth weeks of pregnancy, peaking around weeks 9 to 13. It usually goes away between 16 and 18 weeks of pregnancy.

2. Can Hyperemesis Cause Miscarriage?

No. Generally, hyperemesis gravidarum does not result in miscarriage. In fact, mothers with NVP or HG have a lower chance of miscarriage, as these conditions are typically accompanied by elevated levels of pregnancy hormones, which suggest a healthy pregnancy.

3. Can Hyperemesis Cause Birth Defects?

Low birth weight (LBW), preterm birth (PTB), small-for-gestational-age (SGA), and perinatal death have all been linked to hyperemesis gravidarum (HG).

References –

1. Hyperemesis Gravidarum
   https://www.sciencedirect.com/science/article/abs/pii/S0889854508000442
2. Treatment of Hyperemesis Gravidarum
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3410506/
3. Hyperemesis gravidarium: Epidemiologic findings from a large cohort
   https://www.sciencedirect.com/science/article/abs/pii/S0002937805004503