Hyperemesis gravidarum, or excessive vomiting, is an uncommon and unpleasant condition that can occur during pregnancy. It’s rare enough to have an incidence rate of only 3 in 100 pregnant women, according to the March of Dimes. It is characterized by severe nausea and vomiting that can cause dehydration and weight loss.

What does hyperemesis gravidarum look like?

The best way to describe hyperemesis gravidarum (“excessive vomiting”) is that it is an extreme version of morning sickness. Morning sickness is a term for nausea that is the result of surging pregnancy hormones. It is a classic sign of pregnancy that typically starts at around 4 to 6 weeks of gestation. Most women report that their morning sickness tapers by the time they are 20 weeks along.

With hyperemesis gravidarum, the nausea and vomiting will start early in the first trimester, much like normal morning sickness. The extreme symptoms usually reach a peak at 9 to 13 weeks, but may persist throughout the pregnancy. If your morning sickness is getting worse at 13 weeks or more, speak with your doctor.

Hyperemesis gravidarum symptoms include the following:

• Extreme salivation
• Inability to keep anything down
• Weight loss
• Dehydration and associated symptoms
• Constipation

What causes Hyperemesis Gravidarum?

There is no certain answer as to the cause of excessive vomiting in pregnancy. According to the NIH, there is some evidence that it is related to the surge of hormone levels, specifically a hormone called hCG. Two genes have also been linked to severe morning sickness, GDF15 and IGFBP7.

If a woman has this condition during her first pregnancy, she has an increased chance of experiencing it during any subsequent pregnancies. Other risk factors include:

• Being pregnant with multiples
• A history of migraines or motion sickness
• An older maternal age
• Having a first-degree relative with this condition
• A molar pregnancy (previous or current)

Complications during pregnancy

Because of the intense vomiting of hyperemesis gravidarum, there are potential complications to look for.

• Weight loss
• A decline in kidney function resulting in reduced urine production
• Dizziness and weakness caused by mineral imbalance (electrolytes, sodium, and potassium)
• The need for IV fluids due to dehydration induced by vomiting

Most of the complications from hyperemesis gravidarum will be a concern for the mother, rather than the child she carries. A medical professional should closely supervise your pregnancy as it progresses to monitor the health of both you and the baby. Some complications may occur during pregnancies where hyperemesis gravidarum is present and the mother requires hospitalization.

• Potential low birth weight
• Preterm birth
• Lifestyle issues that may include loss of lifestyle, employment, and other psycho social issues
• Post-cesarean nausea and vomiting

What’s the treatment for Hyperemesis Gravidarum?

Treatment of hyperemesis gravidarum will depend on the severity of nausea and vomiting and whether or not prescription medications are helping. Lifestyle changes can help reduce symptoms as well. Sometimes hospitalization is required to get the vomiting under better control.

Your doctor should start by assessing your worst symptoms, starting with nausea and moving to levels of vomiting and whether or not dehydration/malnutrition are present. From there, they can determine the best way to alleviate symptoms.

Lifestyle changes

Some of the lifestyle changes a doctor may recommend include:

• Eating small amounts of food at more frequent intervals
• Drinking fluids in smaller amounts and more frequently throughout the day
• Identifying if certain temperatures or textures of food trigger nausea (and avoiding them)
• Getting as much sleep as possible

Medications

These vitamins and medications may offer some relief for hyperemesis gravidarum. Always consult with a medical professional before taking any over-the-counter products.

• Diclegis: This is a medication that can be prescribed by a doctor to treat nausea and vomiting.
• Vitamin B6: This vitamin is usually prescribed in combination with Unisom during pregnancy for nausea (Diclegis).
• Vitamin B1: Up to 1.5 mg daily could ease the vomiting of hyperemesis gravidarum.
• Ginger: When taken in small doses (1 to 1.5 grams per day), ginger is supposed to help settle the stomach. Ginger can be taken in the form of tea, lollipops, or candies. You can find some products with ginger as a featured ingredient in most grocery stores.
• Antacids: These can help relieve the burning sensation and discomfort of heartburn.
• Peppermint: Much like ginger, peppermint can also help settle the stomach.

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Our Services include prenatal care, digital mammography, bone density screening, ultrasounds, contraception, menopause, and more. For more information about how our comprehensive women’s healthcare can help you, please give us a call at (806) 355-6330.