Hyperemesis Gravidarum

Pregnancy is a time of many changes, both physical and emotional. Most of these changes are happy ones, and as you begin to get ready for baby's arrival, you will probably find yourself getting more and more excited. However, some pregnancy changes can be quite uncomfortable, especially when it comes to morning sickness. The majority of pregnant women experience morning sickness at some point in their lives, but for a number of women this nausea and vomiting can be persistent and unbearable. When morning sickness becomes extremely severe, it is known as hyperemesis gravidarum.

What is Hyperemesis Gravidarum?
Hyperemesis gravidarum is a rare disease that occurs during pregnancy. Characterized by severe nausea and persistent vomiting, hyperemesis gravidarum is much worse than typical pregnancy morning sickness. Unlike regular morning sickness, hyperemesis gravidarum can cause severe weight loss, nutritional problems, and dehydration. Hyperemesis gravidarum affects approximately 50,000 women in the United States every year.

What Causes Hyperemesis Gravidarum?
Unfortunately, researchers are still unsure exactly what causes hyperemesis gravidarum. It was once believed that this disease was purely psychological, however, this is now known not to be the case. The disease does appear to be biological in origin, but the exact cause remains a mystery. Possible causes of the hyperemesis gravidarum disease include:

  • high levels of the pregnancy hormone, hCG (Human Chorionic Gonadotropin)
  • high levels of estrogen during pregnancy
  • the Helibacter Pylori infection (which causes stomach ulcers)
  • thyroid imbalances
  • Vitamin B deficiency
  • acid reflux disease

Researchers are continuing to study hyperemesis gravidarum in the hopes of finding the exact cause of the disease.

Who Gets Hyperemesis Gravidarum?
Hyperemesis gravidarum is a relatively rare illness during pregnancy, occurring in approximately 1% of pregnant women. Though any woman can potentially develop the disease, there do appear to be certain factors that can increase your risk of getting hyperemesis gravidarum. These risk factors include:

  • carrying twins
  • having previous hyperemesis gravidarum
  • being of young maternal age
  • being obese

Symptoms of Hyperemesis Gravidarum
The symptoms of hyperemesis gravidarum typically begin around the sixth week of pregnancy. Usually, symptoms disappear around the 20th week, however, in about 5% of women, symptoms can continue throughout the third trimester. Symptoms include:

  • persistent nausea
  • uncontrollable vomiting
  • vomiting blood or bile
  • dehydration
  • nutritional deficiencies
  • severe weight loss (at least 5% of pre-pregnancy weight)
  • increased heart rate
  • shivering
  • extreme fatigue
  • increased salivation

Complications of Hyperemesis Gravidarum
Hyperemesis gravidarum is a serious illness that can pose potential health complications. If left untreated, hyperemesis gravidarum can lead to continued weight loss and malnutrition, which may become life threatening. The illness also causes extremely poor quality of life. If vomiting continues, there is a risk of developing liver or stomach complications. The disease is also associated with an increased risk of gallbladder disease.

Though serious, hyperemesis gravidarum does not appear to pose any severe complications for your baby. If treated immediately, most babies are born completely healthy. However, if treatment is not pursued, there is an increased risk of going into preterm labor or having a baby with a low birth weight. Certain drug treatments given to mothers with hyperemesis gravidarum have been known to cause defects in baby.

Hyperemesis Gravidarum Treatment
Treatment is essential if you are suffering from hyperemesis gravidarum. If you are diagnosed with the disease, you will be hospitalized in order to increase your fluid intake and restore any nutritional imbalances. Those who are severely ill may need to be fed through a tube.

Your health care provider will likely prescribe some drugs to control your nausea and vomiting. Some of these medications have unknown side effects on unborn babies, so it is important to weigh all of the risks before taking any medications. Your health care provider will discuss these risks with you. Common medications for the illness include:

  • Antihistamines (such as Diclectin)
  • Corticosteroids (such as Medrol)
  • Phenothiazines (including Haldol and Thorazine)

Some women opt to use natural treatment methods to handle side effects of the illness. Acupuncture, acupressure, and hypnosis have proven to be effective treatments, and produce no side effects in baby.

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