Hyperemesis Gravidarum – Causes, Symptoms, Diagnosis, & Treatment


What is hyperemesis gravidarum?
Hyperemesis gravidarum refers to severe, persistent nausea and vomiting during pregnancy. It can result in dehydration, weight loss, and electrolyte imbalance. This condition is a severe form of morning sickness. Morning sickness is mild nausea and vomiting that occurs in early pregnancy. Mild morning sickness is common. Hyperemesis gravidarum is less common and more severe.

What causes hyperemesis gravidarum?
Most women have morning sickness, particularly during the first 3 months of pregnancy. The exact cause of nausea and vomiting during pregnancy is not known. However, it is believed to be caused by a rapidly rising level of human chorionic gonadotropin (HCG) in the blood. HCG is a hormone released by the placenta. Women with hyperemesis gravidarum have extreme nausea and vomiting during pregnancy. It can cause a weight loss of more than 5% of body weight. The condition can happen in any pregnancy but is a little more likely if you are pregnant with twins (or more babies), or if you have a hydatidiform mole.

Women are at higher risk for hyperemesis if they have had the problem in previous pregnancies or are prone to motion sickness.

What are the symptoms of hyperemesis gravidarum?
Morning sickness can cause decreased appetite, mild nausea, or vomiting. Women with morning sickness are able to eat and drink fluids some of the time. But, women with hyperemesis gravidarum find it difficult to eat and drink, as the symptoms are much more severe.

The following are the common symptoms of hyperemesis gravidarum:

  • Severe, persistent nausea and vomiting during pregnancy
  • Salivating a lot more than normal
  • Weight loss
  • Signs of dehydration such as dark urine, dry skin, weakness, lightheadedness or fainting
  • Constipation
  • Inability to take in adequate amounts of fluid or nutrition

How is hyperemesis gravidarum diagnosed?
Your doctor will do a physical exam and review your symptoms. The doctor may find your blood pressure to be low and pulse to be high.

The following laboratory tests will be done to check for signs of dehydration:

  • Complete blood count
  • Electrolytes
  • Urine ketones
  • Weight loss

Your doctor may do some additional tests to make sure you do not have liver and gastrointestinal problems.

A pregnancy ultrasound will be done to see if you are carrying twins or more babies. Ultrasound also checks for a hydatidiform mole.

How is hyperemesis gravidarum treated?
Morning sickness can most often be managed by avoiding triggering foods that trigger the problem and drinking plenty of fluids when the symptoms let up in order to stay hydrated.

If your nausea and vomiting cause dehydration, your doctor will give fluids through an IV. The doctor may also give anti-nausea medicine. If nausea and vomiting are so severe that you and your baby might be in danger, the doctor will admit you to a hospital for treatment. If you can’t eat enough to get the nutrients you and your baby need, you may be given extra nutrients either through an IV or a tube placed into your stomach.

Try the following tips to help manage symptoms at home:

Avoid triggers. You may notice that certain things can trigger nausea and vomiting. The following are the possible triggers:

  • Certain noises and sounds, even the radio or TV
  • Bright or blinking lights
  • Toothpaste
  • Smells such as perfume and scented bathing and grooming products
  • Pressure on your stomach (wear loose-fitting clothes)
  • Riding in a car
  • Taking showers

Eat and drink when you are able. Take advantage of the times you feel better to eat and drink. Eat small, frequent meals. Try dry, bland foods such as crackers or potatoes. Try eating any foods that appeal to you. See if you can tolerate nutritious smoothies with fruits or vegetables.

Increase fluids during times of the day when you feel least nauseated. Seltzer, ginger ale or other sparkling drinks may help. You can also try using low-dose ginger supplements or acupressure wristbands to ease symptoms.

Vitamin B6 (no more than 100 mg daily) has been shown to decrease nausea in early pregnancy. Ask your doctor if this vitamin might help you. Another medicine called doxylamine (Unisom) has been shown to be very effective and safe when combined with Vitamin B6 for nausea in pregnancy. You can buy this medicine without a prescription.

This feature is for informational purposes only and is not intended to substitute the expert guidance of a doctor. We advise seeing a doctor if you have any health concerns.

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