Hyperemesis Gravidarum – More Than Morning Sickness

Hyperemesis Gravidarum - More Than Morning Sickness

Hyperemesis Gravidarum

Morning sickness is one of the earliest signs of pregnancy — almost a rite of passage into this new stage of your life.

Sometimes morning sickness lasts all day, and sometimes it doesn't happen in the morning at all but the afternoon or evening.

For some women, though, morning sickness becomes extreme — the nausea and vomiting of pregnancy may keep her from getting the nutrition she needs.

Called Hyperemesis Gravidarum (HG), this illness in some cases can lead to dehydration, metabolic disruption, and weight loss for the mother-to-be, as well as growth restriction or preterm birth for baby, among other complications.

While not every mother will experience the worst difficulties, all moms with Hyperemesis Gravidarum need treatment and support.

Hyperemesis Gravidarum is characterised as severe nausea and vomiting associated with pregnancy that results in weight loss and metabolic issues. Women with Hyperemesis Gravidarum experience disruptions in hydration and proper nutrition, and may lose 5%-10% of their pre-pregnancy body weight.

In severe cases, hospitalisation with intravenous hydration and nutrition is needed. Hyperemesis Gravidarum is extremely debilitating and interferes with your normal daily routine. It typically begins very early in pregnancy and continues to 21 weeks or longer.

What Causes Hyperemesis Gravidarum?

Researchers don't know the exact cause of Hyperemesis Gravidarum, but they do have some theories. One belief is that the sudden changes in hCG, oestrogen and progesterone in early pregnancy disturb the balance of hormones for some women.

Other researchers have explored the relationship between Hyperemesis Gravidarum and thyroid hormones, since many women with this illness have elevated thyroxine levels. Another thought is that the same hormones that support pregnancy slow digestions as well. As a result, the gastrointestinal muscles may be slack enough that they cause regurgitation and related nausea and vomiting.

An unlikely theory that persists is that Hyperemesis Gravidarum is related to a woman's mental state — but most researchers agree that the psychological changes are because of the illness rather than at the root of it.

So the best answer is that researchers don't know exactly what causes Hyperemesis Gravidarum, and the cause may be different for different women. More research is needed in this area.

Do I Have Hyperemesis Gravidarum or Just Morning Sickness?

Nearly half of pregnant women suffer from nausea and vomiting of pregnancy (NVP), or ‘morning sickness,' that usually resolves without treatment by the end of the first trimester. While it may be challenging, it is not as incapacitating as HG. NVP typically does not cause weight loss or your ability to eat and drink enough each day. Though you may vomit occasionally with NVP, diet and lifestyle changes tend to help you feel better.

Women with HG, however, lose as much as 5-20 pounds (approx. 2-9 kgs), cannot eat or drink enough to maintain even a low level of hydration, suffer nearly unending nausea, and vomit severely (sometimes even vomiting blood and bile). Changes in diet that are often recommended, including bland foods and not letting your stomach get empty, aren't enough to keep nausea at bay. Mothers-to-be with Hyperemesis Gravidarum often cannot work, and need help with daily self-care.

What Are The Health Consequences For The Mother-To-Be?

While most women don't have any lasting health consequences from Hyperemesis Gravidarum, some women suffer complications. Unabated dehydration can lead to kidney stones, and even possibly renal failure. The severe fatigue may lead to muscular atrophy.

Not only do women with Hyperemesis Gravidarum have nutritional inadequacies, but they may suffer tears in the oesophagus from persistent vomiting and changes in the gastrointestinal tract including pH imbalance and gastric ulcers. Hyperemesis Gravidarum can also lead to deconditioning of the heart muscle, a decrease in blood volume, deficits in blood clotting, and constriction of blood vessels in the brain. The liver can be affected, potentially causing jaundice, and the spleen may separate from its normal location.

All body systems are affected by Hyperemesis Gravidarum. Women whose Hyperemesis Gravidarum is adequately treated as early in pregnancy as possible are at a lower risk for long-term health problems related to the HG.

What Are The Potential Complications For Baby?

Some researchers believe that chronic stress for a pregnant mother may lead to future health consequences for a fetus. Other complications include an increased risk of preterm birth, low birth weight, congenital heart defects, neural tube defects, and more. These consequence are theoretical because no studies have tracked the long-term health of babies born to women with Hyperemesis Gravidarum.

How Is It Treated?

Intravenous rehydration is typically the first line of treatment for Hyperemesis Gravidarum. This sometimes requires hospitalisation, with the length of therapy will depend on the severity of the symptoms. Often bed rest is recommended, and even if not, the fatigue a mother experiences leads to this anyway. Since maternal nutritiona is so important during pregnancy, nutritional therapy is often included as part of the HG treatment. This may mean parenteral nutrition (nutrition intravenously) in severe cases, and in milder cases, just working with a dietician to ensure the mother-to-be is taking in adequate calories and nutrients.

Medications are often part of the treatment regimen for women with Hyperemesis Gravidarum. The drugs most often prescribed for Hyperemesis Gravidarum fall into these categories: serotonin antagonists, corticosteroids, antihistamines, phenothiazines, anti-reflux medications, antispasmodics and prokinetic agents.

No drug is completely safe in pregnancy, but the benefits of pharmacologic therapy in most cases of hyperemesis greatly outweigh the risks.

What Can Support People Do To Help?

Partners and other support people may question if her symptoms are actually as severe as they seem — the best thing you can do is believe her, and to do anything you can to support her through this challenging time. She may need you to help her with even the most basic daily tasks. If you have other children, she will likely need help caring for them. She may feel anxious and depressed — these are common occurrences with Hyperemesis Gravidarum. She may need someone to advocate for her with healthcare providers, who may not have experience with her condition. Keep in mind that even when the nausea and vomiting abate, she will need to recover from this prolonged period of illness while still growing a baby inside — continued support may be needed for things like housekeeping, childcare and employment-related duties.

Will I Have HG Every Time I Am Pregnant?

Because no one knows what causes Hyperemesis Gravidarum, it cannot be prevented. But having gone through it once, you can be prepared. You will likely recognise the symptoms and seek treatment sooner with subsequent pregnancies. This early treatment may lessen the symptoms and severity of the HG.

The absolute best resource for mothers experiencing Hyperemesis Gravidarum is the Hyperemesis Education and Research Foundation. Visit their website at www.helpher.org for mother-to-mother forums, research, blog posts, and more. Share the website with your healthcare provider ” he or she can find a recommended protocol, as well as practice tools and current research. Share it with your family and friends so they can learn more about your condition, including the best ways to help. And share your experience with others through the Support Forums.

You don't have to suffer with severe morning sickness. Find a physician who will take your symptoms seriously, and who will help you find a treatment regimen that works for you.

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BellyBelly CONTRIBUTOR

BellyBelly.com.au


9 comments

  1. I really wish I had received help with this in my two pregnancies. No one understood how debilitating it was and just kept telling me to eat ginger and it would soon end – totally useless advice. The second time around I knew nothing helped which was easier than constantly trying things that didn’t work and made it worse. My advice is to eat as well as possible before getting pregnant and find people who understand how seriously it affects your mental health as well. I was really worried how it might affect my baby and it was just so gruelling to endure. Best of luck to others going through it and to those not, be kind.

    1. I am going through the exact same thing right now. It started from the 12th week and still going on now. Nausea and vomiting more than twice a day. I still have not been hospitalized yet. But I had taken 1 sick leave from work because I was really feeling week. My boss would not want me away from work just for the “so called morning sickness” not understanding the seriousness of what we, with HG are going through. All I can do now is keep forcing myself to eat and to drink as many water as possible, even though it never stays. But I urge mothers with HG, never to give up when things get rough, because what we carry are Blessings, and they deserve all the strength we can provide ourselves to get them to survive these moments with us. To all ladies out there with HG, best of luck and blessings coming your way.

      1. Thank you for the encouragement. I know this is a blessing for our life so, we shouldn’t be disappointing ourselves. I’m experiencing HG and it looks like nothing helps me to get it better… neither moral support nor medical treatment. But all I can do to make it better is not to think much on much and try to get involved in some activities or my work so that my days can go quicker. Sometimes, I tell myself come on this is just a matter of few month or more and then I would be free of it stress and more blessings than ever. So, all I would say is encouraging yourself and look forward to the betterment of your life would relief more. I’m 9weeks now, non of my near ones aware about my pregnancy except my hubby. We are not gonna tell until my next ultra sound done. Good luck ladies.

  2. Im 12w6days pregnant and ive off work for nearly 3weeks. This condition is terrible. My husband and i tried so long for this little miracle. Im trying everyday to little things at home but im so exhausted. I feel so sad that i cant be like most women who are glowing at this stage. I haven’t been able to be excited yet. If theres anyone who can help with coping please let me know. The worst thing is ppl are saying “im staying at home because of a little morning sickness “nobody understands.to anyone else suffering out there try to rest and eat slowly.

  3. I had this my whole pregnancy and was hospitalised 5 times I was monitored for 6 hours each time and stayed over night about 3 times out of th 5 times and the only medication that seemed to work was “ondansetron wafers” they are used for cancer patients and dissolve on the tongue very expensive tho, I ended up having my baby on his due date induced as I had pre-eclampsia as well and he was only 6 pound 13 so average size still small tho and I wouldn’t wish this sickness on anyone I had this from 5 weeks until the very day he was born

  4. I am suffering HG since week 9 and I am 23 weeks now. I was hospitalized for 6 times so far. I am in total depression. I am afraid that my baby will be born with health problems. I eat almost crust of bread and a spread of jam or boiled potatoes. He is my miracle after 6 years of trials to conceive. I cant imagine spending the remaining period like this. Please God help me.

    1. Hi, I too suffer from this from 6 weeks pregnant. I am now 17 and it is waring off! At one point I didn’t think I would be able to cope any longer but there is light at the end of the tunnel. I have been hospitalised 5 times now, down to 7 stone! I finally got the okay to get regular anti sickness injections from my GP and ensure drinks (contain 330 cals per drink) to take along with any food I can on the “not so bad days” (not that they come often). I’m not sure if you could try the same? Hope this helps

  5. Dear Future Mother who is suffering badly

    I can feel your pain. I have been there twice before. I know you’re constantly nauseous, you’re vomiting non stop, you may even vomit up blood and bile, you’re hearing people say it’s just a bit of morning sickness and to eat a dry toast. You want to tell everyone to eff off. You feel alone, depressed and sad. You feel you can’t do this anymore. You may even struggle reading this, having to re-read it several times.

    You’re not alone, you are suffering one of these most horrendous illnesses I’ve ever had. It’s been 13 years and I’m still adamant on finding a solution.

    It’s March 2017 and they have found that micronized progesterone helps a loootttt! Ask your Dr for it. Cry on your Dr for it. This will pass and you’ll have a healthy baby. Hang in there. There were many before you who didn’t have any pills and we made it and our babies are perfectly healthy. Yours will be too. You will be OK. I promise. Just hang in there. One day at a time beautiful ladies

  6. I had Hyperemesis Gravidarum with all five of my children. The first two were born in 1970 and 1971 and I was given a medicine that worked…later taken off the market because of so many law suits. Started having more children in 1987. Horribly ill. When I was 3 months pregnant with the 4th, my oldest left home for college. I was sad like most parents. I was so sick I couldn’t walk and I spiraled into severe depression. (Very poor doctoring didn’t help this “perfect storm”!) I had a complete break down and my mind left planet earth. Hospitalized 40 days on mental floor. Still severely depressed when I came home for months. Changed doctors. Yeah!!! Suffered badkly from depression until I could start on an old-time antidepressant the Mao Clinic said was safe late-on in pregnancy. Saved my & my son’t lives! I am a very committed Christian. It all had nothing to do with my faith. With my 5th child I had a good doctor. Hospitalized me right away for dehydration. Tried Reglan on me twice for nausea, but it made me seize. So I was given a Benadryl shot both times and I felt much better for a couple of hours, got out of bed, walked around talking to the nurses……until it wore off. The doctor sent me home telling me to take the Reglan and to take Benadryl with it to fight the seizure. Did that a few days. Then realized that the Benadryl was what was making me feel better. Talked to doc. He said Benadryl does not cross the placental barrier. So, with his blessing, I took Benedryl at the maximum dose (4 pills at a time) and I took those 4 pills four times a day. It worked, praise God! I took it for several months….no other meds. I returned to work (school cook) soon after starting just Benedryl! First thing the doctor said when my daughter was born was, “Well, here’s our little Benedryl baby!” She is 24 now, very beautiful, graduated nursing school second in her class, is a very committed Christian and BSN (Bachelor of Science in Nursing.) Of course, my 4th son and I have a special bond to this day. We literally went to hell and back together!

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