Hyperemesis gravidarum (HG) or severe too much vomiting during pregnancy is a rare but serious condition. The condition is accompanied by nausea, loss of weight (>5% of pre pregnancy weight), electrolyte disturbance, and acid base imbalance. In severe cases too much vomiting can also lead to the death of the expecting mother.

The condition does not harm the baby.

 

Causes

HG usually begins between the 4th and 7th week of pregnancy and stops by the 20th week. However, in some women the condition continues until the end of pregnancy.

The exact cause of HG is not known.  Hyperemesis gravidarum tends to run in families and if a close family member has a history of HG then you are at risk of having the condition. Other causes of severe vomiting during pregnancy may include:

  • First pregnancy (primigravida)
  • Pregnant with twins or triplets
  • Pregnant with a girl child
  • Travel sickness
  • Obesity at the start of pregnancy

 

If HG starts after 12 weeks of pregnancy, then there are chances that the woman may be suffering from:

  • An upset stomach
  • Urinary tract infection (UTI)
  • Thyroid disease
  • Diabetes

 

Signs and symptoms of Hyperemesis gravidarum

Apart from nausea, weight loss and dizziness, the pregnant female may suffer from:

  • Mood changes
  • Irritability
  • Decreased concentration
  • Symptoms of Depression
  • Metallic taste in the mouth
  • Anxiety

 

How is Hyperemesis gravidarum diagnosed?

A detailed history and physical examination may be helpful in diagnosing HG. The health care provider may check the vital signs along with measuring blood pressure in both sitting and lying position. Other tests that may be done:

  • Thyroid stimulating hormone levels
  • Ultrasound of the abdomen
  • CT scan of the abdomen
  • Electrocardiogram (ECG)
  • Liver enzymes and bilirubin level
  • Urine culture
  • Calcium level
  • Serum level of electrolytes
  • Urinalysis
  • Hepatitis panel

 

Treatment of Hyperemesis gravidarum

The treatment depends upon the symptoms. The condition can be managed by providing supportive care and making alterations in diet.

The physician may prescribe antihistamines or antiemetic to control nausea and vomiting. Nausea can also be controlled by natural remedies, such as ginger or vitamin B6. The pregnant woman is advised to drink plenty of fluids and eat frequent small meals.

At times, in severe cases termination of pregnancy can be considered.

 

Prognosis of Hyperemesis gravidarum

HG gets cured by itself after the baby is born. Talking regularly with your physician can help reduce the symptoms. Women should also undergo counselling to manage the psychological distress due to the condition.

 

Complications of Hyperemesis gravidarum

Complications of HG may include:

  • Loss of 5% of the pre pregnancy weight.
  • Less urine output, this can cause renal failure.
  • Muscle weakness due to electrolyte imbalance.
  • Increased saliva.

 

When should you visit a doctor?

Women should consult their doctor in case of:

  • Severe vomiting
  • Inability to eat and drink without vomiting
  • Loss of weight during pregnancy (>5%)
  • Loss of fluids from the body
  • Fever
  • Too much weakness
  • Blood in vomiting
  • too much vomiting

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Hyperemesis gravidarum is a rare but serious disorder that occurs during pregnancy. However, its symptoms can be managed by being in regular touch with your doctor and getting prompt treatment of the symptoms.

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