HYPEREMESIS GRAVIDARUM

 Basic information

description

Hyperemesis gravidarum is severe, persistent nausea and vomiting in a pregnant woman. It is more serious than the typical nausea and vomiting (morning sickness) in pregnancy. Hyperemesis gravidarum usually occurs before the 20th week of pregnancy; often between the fourth and twelfth week.

FREQUENT SIGNS & SYMPTOMS

• Severe and frequent nausea and vomiting.
• Fatigue, weakness, and feeling faint or lightheaded.
• Sleep problems.
• Smell and taste changes. Excessive saliva.
• Dehydration (less urine, skin may be pale and dry).
• Failure to gain weight, or there is weight loss.
• Unable to eat and maintain proper nutrition.
• Some affected women may have a distinct odor to their breath (ketonic odor).
• Often unable to work, perform daily household tasks and routines, or care for young children.
• Fast heartbeat (sometimes).
• Mood changes, anxiety, depression, irritability, or loss of concentration.
• Symptoms may start, stop, and then recur.

causes

The exact cause is unclear. Multiple factors are likely involved including changes in hormone levels.

risk increases with

• First pregnancy.
• Multiple-pregnancy (more than one fetus).
• Hyperemesis gravidarum in a previous pregnancy.
• Overweight.
• Trophoblastic disease (pregnancy-related condition).
• Liver disease or thyroid or parathyroid problems.

PREVENTIVE MEASURES

• There is no specific prevention. Women who take a multivitamin at the time of conception and in early pregnancy may have a reduced risk.
• Pregnant women who have had hyperemesis gravidarum in a prior pregnancy should discuss possible preventive measures with their obstetric provider.

expected outcomes

Usually curable with time and treatment. Pregnancy can continue to the successful delivery of a healthy baby.

possible complications

• Severe dehydration and weight loss that can lead to a number of complications for mother and baby.
• May increase the risk of preterm birth and baby having a lower than normal birth weight.
• Problems with social or psychological (mental) issues may be associated with this disorder.

 diagnosis & treatment

general measures

• Your obstetric provider will usually do a physical exam and ask questions about your symptoms. Medical tests may be done to check for other health problems.
• Hospital care may be needed to replace lost fluids and electrolytes (substances needed for body function). Fluids are given through a vein (IV) to provide nutrition and relieve dehydration. Other forms of nutritional support may be required (e.g., tube feeding).
• If symptoms are not too severe, home care with diet instructions and rest may be recommended. In some cases, home IV fluids are a part of the treatment.
• You and your obstetric provider may discuss alternate treatments for nausea and vomiting. These can include acupressure wristbands or nerve stimulation device (used to help motion sickness), hypnosis, or others.
• To learn more: Hyperemesis Education and Research Foundation, 932 Edwards Ferry Rd., #23, Leesburg, VA 20176; website: www.helpher.org.

medications

• Intravenous (IV) fluid, vitamins, and electrolyte replacement may be required.
• Other drugs may be prescribed for nausea.
• Don't use any nonprescription drugs or herbal products to prevent vomiting without medical advice.

activity

Increased rest benefits most patients.

diet

• Eat when hungry. Eat small, frequent, and bland meals. High-protein snacks may help. Avoid fatty or spicy foods.
• Drinking seltzer or sparkling water may be helpful.
• Eat dry toast or crackers before you get out of bed.
• Avoid foods and odors that trigger nausea/vomiting.

 notify our office if

• You or a family member has symptoms of hyperemesis gravidarum.
• Symptoms continue despite treatment.

Special Notes: