Hyperemesis Gravidarum: Severe Morning Sickness

By:    Published: December 21, 2012

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Thanks to the highly publicized case of the Duchess of Cambridge and her unfortunate case of hyperemesis gravidarum, the condition that was once something that few had ever heard of is becoming more well known. While some people still think that it's just a little case of morning sickness, when it comes to hyperemesis gravidarum, or HG for short, that isn't the case.

What Is It And Why Is It A Concern?

Hyperemesis gravidarum is a severe form of morning sickness. While 70 to 80 percent of pregnant women will experience some form of morning sickness according to the American Pregnancy Association, hyperemesis gravidarum is a severe form of morning sickness that can have some serious consequences if it's left untreated. It is relatively uncommon, only affecting about 1 in every 300 pregnancies.

When a woman has HG, the nausea and vomiting can lead to weight loss and imbalances in electrolytes and nutrients. Weight loss during the first trimester of pregnancy isn't usually all that troublesome, as the weight quickly comes back in the second trimester, but rapid weight loss can lead to a host of medical problems, as is commonly seen in people with eating disorders, though HG is NOT an eating disorder.

Electrolytes play an important role in the body. They are essential for carrying electrical impulses across cells, maintaining nerve impulses and muscle functions. If these electrolytes become imbalanced and remain that way for too long, they can result in a variety of problems like heart arrhythmias and even seizures. This is often what kills people who die from an eating disorder. However people can also experience problems with muscle function, making it difficult to even walk.

While the Duchess of Cambridge is the most famous face in recent history to be afflicted with the condition, another famous Briton is thought to have died from the condition, probably due to a lack of knowledge and advanced medical treatment. Charlotte Brontë, famed English writer, died in 1855 when four months pregnant after suffering with HG.

Signs And Symptoms

The most commons signs and symptoms of HG are the same as morning sickness, only substantially more severe. They include:

  • Nausea and vomiting – with morning sickness the severity can vary, but it’s usually manageable. With severe morning sickness, it is debilitating. Also, the nausea and vomiting of morning sickness subsides around the 12th or 13th week, but the vomiting of HG does not. The vomiting of HG leads to severe dehydration and does not allow the pregnant woman to keep food down. This is not the case with regular morning sickness.
  • Weight Loss – while weight loss is possible with morning sickness, in HG, it accounts for a loss of five percent of the total pre-pregnancy body weight.

Other symptoms include:

  • Food aversions
  • Dizziness or fainting
  • Low blood pressure
  • Decreased Urination
  • Headaches
  • Confusion
  • Jaundice (yellowing of skin and the whites of the eyes as a result of disrupted liver function)
  • Extreme fatigue
  • Rapid heart beat

What Causes It?

The exact cause of HG is not known, but it is thought to be related to the rise in hormone levels seen in early pregnancy. The levels of hormones in a woman's body rise in early pregnancy to support the new life growing inside her while the placenta forms. Once it is fully formed, around the end of the first trimester, it becomes the baby's life support system, which takes some of the strain off of Mom. It is thought that women with HG are particularly sensitive to this rise in hormones.

HG usually begins when the mom-to-be is around 4-6 weeks pregnant, which is about the time that most women find out that they are indeed pregnant (because the hormone spike is high enough to be picked up by a home pregnancy test), and the symptoms usually peak around the end of the first trimester, though it's estimated that about 20 percent of women with HG will require treatment for it throughout the remainder of their pregnancy.

What Can Be Done?

The treatment for HG depends upon how severe it is. Often, medication to stop the vomiting, nutrient supplements, antacids and bed rest are enough. Hospitalization is not always needed, though some women will need to replace the fluid lost through intravenous (IV) lines.

  • Tube feeding – either through a nasogastric (NG) tube or through an endoscopic gastrostomy, which is a tube surgically inserted through the abdomen into the stomach.
  • Acupressure – the pressure point for nausea is found on the inside of the wrist. Sea bands are the most convenient way to use acupressure for nausea. They are available at most drug and discount stores and are drug free so they won't interfere with other treatments.
  • Ginger or peppermint – these herbs can be made into a tea or consumed in their whole form.
  • Vitamin B6 – this particular vitamin has been shown to be particularly effective at helping to ease morning sickness in pregnant women and is safe for the baby.

While hyperemesis gravidarum isn't just a little morning sickness, with proper treatment, it doesn't need to ruin the rest of the mom-to-be's pregnancy experience. If a pregnant woman ever has a concern about her morning sickness, she should discuss it with her doctor, because while HG is uncommon, it can be serious if left untreated.

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