Nausea and vomiting is very common in early pregnancy. It is sometimes called "morning sickness" although it can occur at any time of day. Most cases of morning sickness are mild and go away by the middle of pregnancy. Mild cases are not thought to be harmful to the baby. Hyperemesis gravidarum (HG) is a severe version of nausea and vomiting due to pregnancy. . It can cause severe nausea, excessive vomiting, weight loss and electrolyte imbalance. Women who have mild morning sickness may be able to be treated by changing their diets, taking over the counter medications and resting. But when hyperemesis is severe, it may require prescription medications or a hospital stay.
Causes of Hyperemesis Gravidarum
Experts believe that hyperemesis is caused by a rise in hormone levels during pregnancy, but the exact cause is unknown.
Most women who get hyperemesis start having symptoms between the 4th and 6th weeks of pregnancy, and symptoms are at their worst between the 9th and 13th weeks. Most women will start to get some relief sometime between week 14 and week 20, but some women will suffer with HG throughout pregnancy.
Symptoms of Hyperemesis Gravidarum
Women may experience hyperemesis in different ways, but some of the signs and symptoms are:
- severe nausea
- excessive vomiting
- weight loss of 5 percent or more of pre-pregnancy weight
- decreased urination
- extreme fatigue
- low blood pressure
- rapid heart rate
Treatment for Hyperemesis Gravidarum
Treatment for hyperemesis will depend on the severity of the symptoms. Your doctor may recommend eating dry or bland foods and avoiding spicy food and eating before going to bed. Vitamin B6 is the first choice for over the counter medications and an antihistamine called doxylamine (found in some sleep medications) may be recommended next. Ginger may also provide relief for some women. Under the guidance of your doctor, ginger supplements or ginger ale may be helpful. If diet changes, over the counter medications and rest do not provide enough relief, prescription medications for nausea may be recommended. If symptoms are severe, hospitalization may be required.
Hospital treatment may include:
- intravenous fluids (IV fluids) to improve hydration and restore electrolytes, vitamins and nutrients lost through vomiting
- medications for nausea may be given intravenously or by suppository if you cannot take medications by mouth.
- medications may be given to help protect your stomach and esophagus from stomach acid and the effects of vomiting
In some cases, other forms of nutrition may be required if you remain unable to eat for a prolonged time despite treatment.
There is lots of help available to women who are suffering from HG. The HER Foundation provides a lot of valuable information and resources on its website. Your health care provider should also have resources for you if you need them, including helping you find counselors who can help you through some of the emotional effects of HG.