Pregnant woman experiencing Hyperemesis Gravidarum
Hyperemesis gravid arum is extreme, persistent nausea and vomiting during pregnancy. It can lead to:
- Dehydration(dizziness, malaise, reduced BP, reduced pulse rate, reduced urine output
- Weight loss
- Ketones in urine
- Electrolyte imbalances.
- Morning sickness is mild nausea and vomiting that occurs in early pregnancy.
Causes
Pregnancy frequently causes nausea and vomiting. The exact cause of nausea and vomiting during pregnancy is not known. However, it is believed to be caused by a rapidly increasing levels of estrogens or rising blood level of a hormone called human chorionic gonadotropin (HCG). HCG is released by the placenta. Mild morning sickness is common and it can occur at any time of the day. Hyperemesis gravid arum is less common and more severe. It affects only 2% of pregnant women.
Vomiting usually develops at about 5 week’s gestation, peaks at 9weeks and disappears by about 16 0r 18 weeks. Some women will continue to have nausea and vomiting throughout the entire pregnancy.
Women with hyperemesis gravid arum have extreme nausea and vomiting during pregnancy. It can cause a weight loss of more than 5% of body weight. The condition can happen in any pregnancy, but is a little more likely if you are pregnant with twins (or more babies), or if you have a hydatid form mole. Women are at higher risk for hyperemesis if they have had the problem in previous pregnancies or are prone to motion sickness.
Risk factors of Hyperemesis Gravida rum
- Multiple gestation
- Null parity
- Juvenile pregnancies
- Age younger than 24years
- Depression or anxiety
- Obesity
- Pylori infection
- Molar pregnancy
- Previous history of hyperemesis gravid arum
Symptoms
Morning sickness can cause decreased appetite, low level nausea, or vomiting. This is different from true hyperemesis because people are typically still able to eat and drink fluids some of the time.
Symptoms of hyperemesis gravid arum are much more severe. They may include:
- Severe, persistent nausea and vomiting during pregnancy
- Salivating a lot more than normal
- Weight loss
- Signs of dehydration, such as dark urine, dry skin, weakness, lightheadedness, or fainting
- Constipation
- Inability to take in adequate amounts of fluid or nutrition
Exams and Tests
Your health care provider will do a physical exam. Your blood pressure may be low. Your pulse may be high.
The following laboratory tests will be done to check for signs of dehydration:
- Complete blood count
- Liver Function Tests
- Pylori Antigen Test
- Electrolytes
- Urine ketones
- Weight loss
A pregnancy ultrasound will be done to see if you are carrying twins or more babies. Ultrasound also checks for a hydatid form mole.
Treatment
Morning sickness can most often be managed by avoiding foods that trigger the problem and drinking plenty of fluids when the symptoms decrease in order to stay hydrated.
If your nausea and vomiting causes you to become dehydrated or have electrolyte derangements, you will receive fluids through an IV line. You may also be given anti-nausea /anti emetic medicine. If the symptoms are still persistent or with electrolyte abnormalities, the doctor may need to admit you for monitoring and further management. If you can’t eat enough to get the nutrients you and your baby need, you may get extra nutrients either through an IV line or a tube placed into your stomach.
To help manage symptoms at home, try these tips.
- Reduce spicy and fatty foods
- Have small frequent meals when you are able to eat
- Take plenty of fruits and vegetables
- Rehydrate
- Try eating foods that are appealing to you
- Try using ginger
Avoid triggers. You may notice that certain things can trigger nausea and vomiting. These may include:
- Certain noises and sounds, even the radio or TV
- Bright or blinking lights
- Toothpaste
- Smells, such as perfume and scented bathing and grooming products
- Pressure on your stomach (wear loose-fitting clothes)
- Riding in a car
Vitamin B6 (no more than 100 mg daily) has been shown to decrease nausea in early pregnancy. Ask your provider if this vitamin might help you. Another medicine called doxylamine (Unisom) has been shown to be very effective and safe when combined with Vitamin B6 for nausea in pregnancy. You can buy this medicine without a prescription.
Possible Complications
Severe vomiting is harmful because it leads to dehydration and poor weight gain and metabolic disturbances that may be fatal to both mother and baby.