Beyond morning sickness: Hyperemesis gravidarum

by Julie Snyder

feeling nauseatedMost women experience nausea and vomiting during pregnancy, but for a few unfortunate souls, it becomes an uncontrollable monster that dictates their lives.

This condition, hyperemesis gravidarum, typically begins early in the first trimester, extends into second trimester and may last the entire pregnancy. HG can make you feel like all the joy of your pregnancy is literally going down the toilet. Hang in there, there's help!

"My friends don't understand how awful this condition is. They dismiss it by reminding me that most women have morning sickness during pregnancy. Hyperemesis isn't simply morning sickness. It's like constant food poisoning -- for months," says member Melissa from Utah.

What is hyperemesis gravidarum

Hyperemesis gravidarum is a severe form of unrelenting nausea and vomiting in pregnancy. It results in weight loss, dehydration and sometimes electrolyte disturbance. Severe cases often require a stay in the hospital so that the mother can receive fluid and nutrition through an intravenous line.

Hyperemesis gravidarum's exact cause isn't known. Recent research strongly suggests a genetic link. Three times as many women suffer from HG is their mother was diagnosed during one of her pregnancies.
Other risk factors could include, hyperemesis gravidarum during a previous pregnancy, being overweight, having a multiple pregnancy, or being a first-time mother.

The table below illustrates the differences between normal morning sickness and HG:

   Morning Sickness   Hyperemsis Gravidarum
You don't lose much weight You lose more than 5% of your prepregnancy weight
You're able to eat and drink enough each day Because of nausea and vomiting you're able to eat very little and get dehydrated
You don't vomit often and your nausea seems linked to triggers you vomit often and vomit blood or bile if not treated. Nausea is moderate to severe and constant
You improve after the first trimester although you might be a little queasy at times later in pregnancy You usually feel better by mid-pregnancy, but might continue to be nauseous or vomit throughout pregnancy
You're able to continue working and caring for your family You are probably unable to work and might need help caring for yourself

Diagnosing HG

It's usually made by measuring your weight loss, checking for ketones, and assessing your overall health. If you meet the criteria and you're having difficulty performing daily activities, you and your caregiver can brainstorm together to find an effective treatment.

We know that dynamic care early in pregnancy can help prevent life-threatening complications. Many new medications seem to be more effective and don't appear to endanger your baby. Balancing the risks of potential complications and misery with the risks of effective anti-nausea medication continues to challenge providers.

Treating Hyperemesis Gravidarum

The type of treatment required depends on how ill you are. Your plan to prevent nausea and vomiting might include:

• Pressure-point wristband similar to those used for motion sickness
• Vitamin B6 and ginger
• Small frequent meals
• Dry foods such as crackers
• Small frequent meals

If these fail to help, your provider might suggest medicine to prevent nausea, non-traditional techniques, intravenous fluids or total parenteral nutrition.

After your baby arrives

Birthing your baby alleviates the symptoms of HG, but your psyche might not fare as well. For some women severe anxiety and depression follow their troubled pregnancies. Being very sick and feeling like you're going to die can trigger post traumatic stress disorder.

Depending how severe your condition, how quickly you're treated and how much your daily life and job are affected, postpartum recovery can be prolonged. Take the time to seek out support. You might not only be helping yourself, but helping another mom who's suffering just the same.