Hyperemesis Gravidarum is a severe, and potentially dangerous, form of morning sickness where mothers-to-be struggle to keep down any food or liquid, which can lead to dehydration. Unlike most morning sickness, it usually persists past the first trimester, up until around week 21 of pregnancy, although it can last much longer.
It affects fewer than four in every 1,000 pregnant women and is treated by giving fluids intravenously and anti-sickness tablets. It is more often experienced by women expecting twins; mothers-to-be who suffer from the condition are three times more likely to have a multiple birth than other women.
Hyperemesis gravidarum is a condition characterized by severe nausea, vomiting, weight loss, and electrolyte disturbance. Mild cases are treated with dietary changes, rest, and antacids. More severe cases often require a stay in the hospital so that the mother can receive fluid and nutrition through an intravenous line (IV). DO NOT take any medications to solve this problem without first consulting your health care provider.
The Duke and Duchess of Cambridge shared the happy news that they are expecting their third child together on Monday. However as with her previous two pregnancies, it has been revealed that Kate is suffering from Hyperemesis Gravidarum, and has been forced to pull out of a planned engagement at the Hornsey Road Children’s Centre in London.
Why is this happening to me?
The majority of pregnant women experience some type of morning sickness (70 – 80%). Recent studies show that at least 60,000 cases of extreme morning sickness called hyperemesis gravidarum (HG) are reported by those who treated in a hospital but the numbers are expected to be much higher than this since many women are treated at home or by out patient care with their health care provider.
What are the symptoms of Hyperemesis Gravidarum?
As well as severe nausea, vomiting and food aversion, women suffering with hyperemesis gravidarum often feel tired, dizzy and confused. They can also lose around 10 per cent of their body weight. Dehydration is the big danger with the condition and that can cause symptoms that include headaches and palpitations. Because the mother-to-be cannot retain food, there is also a risk of nutritional deficiencies.
The symptoms of hyperemesis gravidarum usually appear between weeks four and six of pregnancy and peak between weeks nine and 13. Most women will experience some relief between weeks 14 and 20, although up to 20 per cent may require care throughout the rest of their pregnancy.
Signs and symptoms of hyperemesis gravidarum:
It is believed that this severe nausea is caused by a rise in hormone levels; however, the absolute cause is still unknown. The symptoms of HG usually appear between 4-6 weeks of pregnancy and may peak between 9-13 weeks. Most women receive some relief between weeks 14-20, although up to 20% of women may require care for hyperemesis throughout the rest of their pregnancy. There is no known prevention of Hyperemesis gravidarum but you can take comfort in knowing that there are ways to manage it.
Other symptoms you may experience
Pregnancy Sickness Support is in touch with many women who have had HG, and who report having some or all of the following symptoms in addition to the main symptoms listed above:
- extremely heightened sense of smell
- excessive saliva production (ptyalism)
- headaches and constipation from dehydration
- pressure sores from long periods of time in bed
- episodes of urinary incontinence as a result of vomiting combined with the pregnancy hormone relaxin
If you experience these symptoms, you are not alone. Many women have them and, although they can be distressing, they will go away when the HG stops or the baby is born.
Other treatments may include:
- Bed Rest –This may provide comfort, but be cautious and aware of the effects of muscle and weight loss due to too much bed rest.
- Acupressure – The pressure point to reduce nausea is located at the middle of the inner wrist, three finger lengths away from the crease of the wrist, and between the two tendons. Locate and press firmly, one wrist at a time for three minutes. Sea bands also help with acupressure and can be found at your local drug store.
- Herbs – ginger or peppermint
- Homeopathic remedies are a non-toxic system of medicines. Do not try to self-medicate with homeopathic methods; have a doctor prescribe the proper remedy and dose.
When it comes to medications, it is very important that you weigh the risks and the benefits. Some drugs may have adverse effects on you or the development of your baby. Discuss the risks and side effects of each drug with your health care provider.
Britain’s Royal family announced that the Duchess of Cambridge Kate Middleton is pregnant and was admitted to a London hospital with severe morning sickness. The hospitalization prompted an early public announcement of the pregnancy — she is said to be less than 12 weeks pregnant.
Morning sickness is often the first sign of pregnancy. It can occur as early as two to eight weeks. Nausea tends to happen because elevated hormone levels may cause food to empty the stomach slowly. Also, pregnancy may make women more sensitive to smells, making certain odors more likely to trigger nausea.
First Signs of Pregnancy
Up to 90 percent of pregnant women experience nausea with or without vomiting and there are things they can do to generally alleviate symptoms, including:
- Eating saltine crackers or dry bread just before bed at night and first thing in the morning
- Eating smaller, more frequent meals so the stomach never completely empties
- Avoiding greasy or fatty food
- Drinking fluids between rather than during meals
- Getting enough rest and taking breaks when energy levels flag
- Avoiding highly seasoned foods, cream and strongly flavored vegetables such as onions
- Taking a total of 1 to 1.5 grams of powdered ginger in divided doses throughout the day (upon advice of a health care professional)
- Taking 25 mg three times a day of vitamin B6 alone or with the antihistamine doxylamine (upon advice of a health care professional)
Pregnancy A-Z Guide
But up to 2 percent of pregnant women suffer from a very severe form of “morning sickness” called hyperemesis gravidarum, which causes extreme nausea and vomiting. For these women, nausea and vomiting may continue all day, every day, and can last beyond the first trimester when morning sickness often subsides. Pregnant women who experience weight loss of more than 5 pounds during the first trimester due to severe nausea and vomiting should discuss the topic of hyperemesis gravidarum with their health care professional.
The severity of symptoms can lead to serious complications that may prevent sufficient weight gain for a healthy pregnancy. General guidelines from the Institute of Medicine recommend that women who were underweight before getting pregnant gain 28 to 40 pounds during pregnancy; normal weight women gain 25 to 35 pounds; overweight women gain 15 to 25 pounds; and obese woman gain between 11 and 20 pounds.
Severe vomiting in pregnancy
Sickness in pregnancy is common. Around 7 out of every 10 pregnant women experience nausea and/or vomiting, and this doesn’t just occur in the morning.
For most women, this improves or disappears completely by around week 14, although for some women it can last longer.
Some pregnant women experience excessive nausea and vomiting. They might be sick many times a day and be unable to keep food or drink down, which can have a negative effect on their daily life.
This excessive nausea and vomiting is known as hyperemesis gravidarum (HG), and often needs hospital treatment.
Exactly how many pregnant women get HG is not known as some cases may go unreported, but it’s thought to be around 1 in every 100.
If you are being sick frequently and can’t keep food down, tell your midwife or doctor, or contact the hospital as soon as possible. There is a risk you may become dehydrated, and your midwife or doctor can make sure you get the right treatment.
Pregnancy Nutrition Dos and Don’ts
The good news is that morning sickness is associated with lower risks of miscarriages and stillbirths and is generally viewed as a sign that hormone levels are rising normally, establishing the placenta.
What causes Hyperemesis Gravidarum?
The precise cause of hyperemesis gravidarum isn’t known – it is thought to be linked to the rise in hormone levels – and as such it isn’t possible to prevent it from occurring. It can however be treated successfully. It tends to be more common in young mothers, women experiencing their first pregnancy and those carrying multiple children.
What is the treatment for Hyperemesis Gravidarum?
Women suffering from hyperemesis gravidarum in its early stages are advised to rest and eat small pieces of dry toast or crackers before getting out of bed. Small frequent meals are also encouraged, although fried foods, or anything else that triggers nausea or vomiting are best avoided. If symptoms are severe, the mother-to-be will be admitted to hospital for a few days for observation and to treat dehydration with intravenous fluids.
How you might feel
The nausea and vomiting of HG can have a huge impact on your life at a time when you were expecting to be enjoying pregnancy and looking forward to the birth of your baby.
It can affect you both emotionally and physically. The symptoms not only make your life a misery, but may lead to further health complications, such as depression or tears in your oesophagus.
Severe sickness can be exhausting and stop you doing everyday tasks, such as going to work or even getting out of bed.
In addition to feeling very unwell and tired, you might also feel:
- anxious about going out or being too far from home in case you need to vomit
- isolated because you don’t know anyone who understands what it’s like to have HG
- confused as to why this is happening to you
- unsure whether you can cope with the rest of the pregnancy if you continue to feel very ill
If you feel any of these, don’t keep it to yourself. Talk to your midwife or doctor, and explain the impact HG is having on your life and how it is making you feel. You could also talk to your partner, family and friends if you want to.
If you want to talk to someone who has been through HG, you can contact Pregnancy Sickness Support’s help section. They have a support network across the UK and can put you in touch with someone who has had HG.
Bear in mind that HG is much worse than regular pregnancy sickness. It is not the result of anything you have or haven’t done, and you do need treatment and support.
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