Hyperemesis Gravidarum: Causes, Symptoms & Diagnosis
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Hyperemesis Gravidarum

What Is Hyperemesis Gravidarum?

Many women experience morning sickness, or nausea, during pregnancy. This condition is generally harmless. While morning sickness can be quite uncomfortable, it typically goes away within 12 weeks. Hyperemesis gravidarum (HG) is an extreme form of morning sickness that causes severe nausea and vomiting during pregnancy.

Morning sickness and HG are very different conditions. They have different complications and side effects for pregnant women. It’s important to distinguish between these two conditions to properly treat symptoms.

Morning sickness typically includes nausea that’s sometimes accompanied by vomiting. These two symptoms typically disappear after 12 to 14 weeks, and the vomiting doesn’t cause severe hydration.

HG typically includes nausea that doesn’t go away and severe vomiting that causes severe hydration and doesn’t allow you to keep any food or fluids down.

Morning sickness typically begins in the first month of pregnancy. It usually goes away by the third or fourth month. Pregnant women with morning sickness can get fatigue and a slight loss of appetite. They may have difficulty performing daily activities

The symptoms of HG begin within the first six weeks of pregnancy, and nausea often doesn’t go away. HG can be extremely debilitating and cause fatigue that lasts for weeks or months. According to the HER Foundation, women with HG may experience a complete loss of appetite and may not be able to work or perform daily activities.

HG can lead to dehydration and poor weight gain during pregnancy. There’s no known way to prevent morning sickness or HG, but there are ways to manage the symptoms.

What Are the Symptoms of Hyperemesis Gravidarum?

Symptoms

HG usually starts during the first trimester of your pregnancy. Less than half of women with HG experience symptoms their entire pregnancy. Some of the most common symptoms of HG are:

  • vomiting more than three or four times per day
  • becoming dehydrated
  • feeling light-headed or dizzy
  • losing more than 10 pounds or 5 percent of your body weight due to vomiting
  • feeling nearly constant nausea

What Causes Hyperemesis Gravidarum?

Causes

Almost all women experience some degree of morning sickness during their pregnancy. Morning sickness is nausea and vomiting during pregnancy. Despite the name, morning sickness isn’t confined to the morning and can occur at any time.

Morning sickness and HG seem to have a connection to human chorionic gonadotropin (hCG). This is a hormone created during pregnancy by the placenta. Your body produces a large amount of this hormone at a rapid rate early in pregnancy. The American Pregnancy Association states that hCG levels typically double every 48 to 72 hours. These levels can continue to rise throughout your pregnancy.

Who Is at Risk for Hyperemesis Gravidarum?

Risk Factors

Some factors that could increase your risk of getting HG are:

  • having a history of HG
  • being pregnant with more than one baby
  • being overweight
  • being a first-time mother

Trophoblastic disease can also cause HG. Trophoblastic disease occurs when there’s an abnormal growth of cells inside the uterus.

How Is Hyperemesis Gravidarum Diagnosed?

Diagnosis

Your doctor will ask you about your medical history and your symptoms. A standard physical exam is enough to diagnose most cases. Your doctor will look for common signs of HG, such as abnormally low blood pressure or a fast pulse. Blood and urine samples may also be necessary to check for signs of dehydration. Your doctor might also order additional tests to rule out gastrointestinal problems as a cause of your vomiting.

An ultrasound, which uses sound waves to create an image of the inside of your body, might be necessary to find out if you’re pregnant with twins or if there’s a mass in your uterus from trophoblastic disease.

How Is Hyperemesis Gravidarum Treated?

Treatment

Treatment for HG depends on the severity of your symptoms. Your doctor may recommend natural nausea prevention methods such as vitamin B-6 or ginger. Try eating smaller, more frequent meals and dry foods such as crackers. You should drink plenty of fluids to stay hydrated.

Severe cases may require hospitalization. Pregnant women who are unable to keep fluids or food down due to constant vomiting will need to get them intravenously, or through an IV. Medication is necessary when vomiting is a threat to the mother or child. The most commonly used anti-nausea drugs are promethazine and meclizine. You can’t take medication orally. You can receive it through an IV or as a suppository. Taking medication while pregnant can cause potential health problems for your baby, but in severe cases of HG, maternal dehydration is a more concerning problem. Talk to your doctor about the risks associated with any method of treatment.

What Is the Long-Term Outlook?

Outlook

The good news is that symptoms of HG will disappear after giving birth. However, the HER Foundation finds that postpartum recovery is often longer for women with HG. Talking with your doctor and pursuing education and support groups can help you and your family deal with the repercussions of HG. The psychological and emotional stress of HG can impact your quality of life, so be sure to communicate your feelings to your doctor and personal support system.

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