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Hyperemesis Gravidarum in pregnancy

What is Hyperemesis Gravidarum?

Hyperemesis Gravidarum (HG) is a medical condition that is a rare and debilitating situation characterized by severe nausea and vomiting during pregnancy. Pregnant women generally experience typical morning sickness, but HG is severe, persistent, and potentially complicated. 

HG can lead to dehydration, weight loss, imbalances of electrolytes, and other complications. During pregnancy, it can significantly affect the overall health and quality of a woman’s life. Do you know morning sickness and hyperemesis gravidarum are both different terms?

What is the difference between hyperemesis gravidarum and morning sickness?

Hyperemesis gravidarum and morning sickness both include nausea and vomiting during pregnancy. But they are different in several ways as morning sickness happens due to minor to moderate pregnancy nausea and vomiting. Women can manage morning sickness by adjusting their lifestyle and diet. On the contrary, HG is severe and involves extreme, persistent nausea and vomiting that occurs throughout the day and night. 

What are the causes of hyperemesis gravidarum?

It is important to understand that the exact causes of hyperemesis gravidarum can vary from woman to woman. While the precise causes can not be fully understood by doctors, there are some factors that contribute to HG development.

HG is a complex medical condition that is the result of genetics, physiology, and hormonal combination. The main causes of HG are:

  1. Hormonal fluctuation:

During early pregnancy, a rapid increase in certain hormones especially in HCG, progesterone,  and estrogen, is one of the primary factors that can trigger HG. These hormones are very important in maintaining a healthy pregnancy during elevated levels, mainly in the first trimester causing severe nausea and vomiting.

  1. Gastrointestinal issues: 

Studies show that HG can be related to gastrointestinal issues. During pregnancy, the normal functioning of a woman’s digestive system can be affected by hormonal changes, causing nausea and vomiting.

  1. Genetics:

Women can inherit HG by genetics from their family who experience hyperemesis gravidarum during pregnancy. This suggests that pregnant women with such genetic factors are more likely to experience severe nausea and vomiting.

  1. Multiple pregnancies:

Women with multiple pregnancies such as twins and triplets can be at a greater risk of HG caused by the high-level production of hormones.

  1. Psychological issues:

Anxiety, stress, and some other psychological factors increase the risk of hyperemesis gravidarum and make it much more severe. Stress makes the condition more challenging and hard to manage by exacerbating nausea and vomiting.

  1. Trophoblast theory:

The trophoblast is a tissue that forms the placenta. This is relatively a recently presented theory that shows HG may be related to trophoblast. Abnormalities in trophoblast development may affect the production of hormones like HCG causing severe nausea and vomiting.

What are the symptoms of hyperemesis gravidarum?

The primary symptoms of HG during pregnancy are:

  1. Nausea:

HG involves severe and unrelenting nausea during pregnancy. It is more than just feeling queasy. Women with such conditions feel deep and constant sickness making it difficult to function properly.

  1. Vomiting:

Morning sickness generally involves infrequent vomiting. But women facing HG, vomit multiple times during the day or every time they are done eating or drinking something. 

  1. Dehydration during pregnancy:

Dry mouth, dry lips, extreme thirst, dark yellow urine, and infrequent urination are the signs of dehydration which are caused by persistent vomiting during hyperemesis gravidarum.

  1. Weight loss:

Women with HG tend to experience weight loss because of the inability to keep food down due to frequent vomiting. HG can decrease weight by 5% of pre-pregnancy weight.

  1. Weakness:

Severe nausea, frequent vomiting, and inadequate nutrition can lead to extreme fatigue and weakness which create difficulties in performing daily routine activities.

  1. Fainting:

Fainting or dizziness is also a symptom of HG which is the result of low blood pressure due to malnutrition and dehydration.   

  1. Food:

It is nearly impossible to ignore certain foods and even the smell of cooking during pregnancy because of HG which leads to a reduction in food intake making the condition much worse.

  1. Mental health:

Hyperemesis gravidarum significantly affects mental health because of constant suffering and isolation. It can lead to stress, anxiety, and depression due to severe symptoms and disturbances in normal life during pregnancy.

What is the treatment of hyperemesis gravidarum?

Treatment of HG includes:

  1. Changes in diet:
  • Eating frequently and regularly by taking small intakes of meals throughout the whole day is much more reliable than taking large meals infrequently. It can help to deal with nausea. 
  • Certain bland foods such as toast, crackers, and plain rice would be easy for the stomach to digest.
  • Hydration is very important and helps a lot in HG. Ginger tea, ice chips, and certain clear fluids help in staying hydrated. 
  1. Lifestyle:
  • Exhaustion during pregnancy can increase nausea and vomiting. Rest and relaxation are very basic needs to reduce these symptoms.
  • Strong odors can make the condition worse. Identifying and avoiding such triggers can help deal with HG.

  1. Medication:
  • Anti-nausea medications such as Zofran, vitamin B6,  Phenergan, and Reglan can help in managing nausea. Use them carefully with the advice of your healthcare professional.
  1. Nutrition:
  • The use of total parenteral nutrition provides nutrients in case of severe weight loss or malnutrition during pregnancy. 
  1. Therapies:
  • The use of acupressure wristbands helps to find relief from nausea.
  • Ginger-containing supplements or foods can be helpful in treating HG.

How long does hyperemesis gravidarum last?

The period of hyperemesis gravidarum during pregnancy can vary from female to female. HG starts in the early weeks of pregnancy generally around the 6 weeks and reaches its peak between the 8 to 12 weeks.

In the first trimester, HG begins and reaches its peak during this duration. In most cases, around 12 to 20 weeks, symptoms begin to improve as women jump into the second trimester.

In the second trimester, some women may continue to face HG but with less severity.

However, in rare cases, some women may experience HG to the end of their pregnancy. In this case, you should go to a healthcare provider.

Will hyperemesis harm my baby?

Generally, with proper treatment of HG, you can reduce the risk of harming both you and your baby. Managing HG carefully helps to minimize the risk of potential harm to the baby. But if you’re not taking it seriously and it is left untreated, there can be a chance of adverse effects on the baby. It can cause preterm birth and low-weight birth due to untreated severe malnutrition and dehydration.

It is very crucial for you to have your condition examined by a healthcare professional. They will monitor your condition and manage it throughout your pregnancy and give the best possible solution for both you and your baby.

Hannah Miller
Writer, Child Development Specialist Expertise Nutritional Needs for Growing Children Picky Eater Strategies Effective Communication Techniques Inclusive Education Techniques Preparing Kids for School Transitions Highlights Founder and Head of Content Strategy for Parenting and Childcare with a specialized focus on nutritional needs for growing children and picky eater strategies. Holds a Master's degree in Child Development from Queens University. Certified in Precision Nutrition, Child Development Associate, and New Parent Education. Experience Hannah Miller, M.Ed., combines academic insights with real-life parenting experience in her writing. Maria crafts articles on topics such as effective communication techniques, inclusive education, and preparing kids for school transitions that resonate deeply with parents and parents-to-be. She offers invaluable resources based on her extensive education, training, and firsthand experience as a parent. In her spare time, Maria enjoys hiking trails and experimenting in the kitchen with culinary delights.

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