Hyperemesis Gravidarum

What is Hyperemesis Gravidarum

Hyperemesis gravidarum is a severe form of nausea and vomiting that happens during pregnancy. Hyperemesis is worse than morning sickness. It may cause you to have nausea or vomiting all day for many days.

It may keep you from eating and drinking enough food and liquids, which can lead to dehydration, malnutrition, and weight loss. Hyperemesis usually occurs during the first half (the first 20 weeks) of pregnancy. It often goes away once a woman is in her second half of pregnancy. However, sometimes hyperemesis continues through an entire pregnancy.

What are the causes?

The cause of this condition is not known. It may be related to changes in chemicals (hormones) in the body during pregnancy, such as the high level of pregnancy hormone (human chorionic gonadotropin) or the increase in the female sex hormone (estrogen).

What are the signs or symptoms?

Symptoms of this condition include:

  • Nausea that does not go away.
  • Vomiting that does not allow you to keep any food down.
  • Weight loss.
  • Body fluid loss (dehydration).
  • Having no desire to eat, or not liking food that you have previously enjoyed.

How is this diagnosed?

This condition may be diagnosed based on:

  • A physical exam.
  • Your medical history.
  • Your symptoms.
  • Blood tests.
  • Urine tests.

How is this treated?

This condition is managed by controlling symptoms. This may include:

  • Following an eating plan. This can help lessen nausea and vomiting.
  • Taking prescription medicines.

An eating plan and medicines are often used together to help control symptoms. If medicines do not help relieve nausea and vomiting, you may need to receive fluids through an IV at the hospital.

Follow these instructions at home:

Eating and drinking

  • Avoid the following:
    • Drinking fluids with meals. Try not to drink anything during the 30 minutes before and after your meals.
    • Drinking more than 1 cup of fluid at a time.
    • Eating foods that trigger your symptoms. These may include spicy foods, coffee, high-fat foods, very sweet foods, and acidic foods.
    • Skipping meals. Nausea can be more intense on an empty stomach. If you cannot tolerate food, do not force it. Try sucking on ice chips or other frozen items and make up for missed calories later.
    • Lying down within 2 hours after eating.
    • Being exposed to environmental triggers. These may include food smells, smoky rooms, closed spaces, rooms with strong smells, warm or humid places, overly loud and noisy rooms, and rooms with motion or flickering lights. Try eating meals in a well-ventilated area that is free of strong smells.
    • Quick and sudden changes in your movement.
    • Taking iron pills and multivitamins that contain iron. If you take prescription iron pills, do not stop taking them unless your health care provider approves.
    • Preparing food. The smell of food can spoil your appetite or trigger nausea.
  • To help relieve your symptoms:
    • Listen to your body. Everyone is different and has different preferences. Find what works best for you.
    • Eat and drink slowly.
    • Eat 5–6 small meals daily instead of 3 large meals. Eating small meals and snacks can help you avoid an empty stomach.
    • In the morning, before getting out of bed, eat a couple of crackers to avoid moving around on an empty stomach.
    • Try eating starchy foods as these are usually tolerated well. Examples include cereal, toast, bread, potatoes, pasta, rice, and pretzels.
    • Include at least 1 serving of protein with your meals and snacks. Protein options include lean meats, poultry, seafood, beans, nuts, nut butters, eggs, cheese, and yogurt.
    • Try eating a protein-rich snack before bed. Examples of a protein-rick snack include cheese and crackers or a peanut butter sandwich made with 1 slice of whole-wheat bread and 1 tsp (5 g) of peanut butter.
    • Eat or suck on things that have ginger in them. It may help relieve nausea. Add ¼ tsp ground ginger to hot tea or choose ginger tea.
    • Try drinking 100% fruit juice or an electrolyte drink. An electrolyte drink contains sodium, potassium, and chloride.
    • Drink fluids that are cold, clear, and carbonated or sour. Examples include lemonade, ginger ale, lemon–lime soda, ice water, and sparkling water.
    • Brush your teeth or use a mouth rinse after meals.
    • Talk with your health care provider about starting a supplement of vitamin B6.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Follow instructions from your health care provider about eating or drinking restrictions.
  • Continue to take your prenatal vitamins as told by your health care provider. If you are having trouble taking your prenatal vitamins, talk with your health care provider about different options.
  • Keep all follow-up and pre-birth (prenatal) visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have pain in your abdomen.
  • You have a severe headache.
  • You have vision problems.
  • You are losing weight.
  • You feel weak or dizzy.

Get help right away if:

  • You cannot drink fluids without vomiting.
  • You vomit blood.
  • You have constant nausea and vomiting.
  • You are very weak.
  • You faint.
  • You have a fever and your symptoms suddenly get worse.

Summary

  • Hyperemesis gravidarum is a severe form of nausea and vomiting that happens during pregnancy.
  • Making some changes to your eating habits may help relieve nausea and vomiting.
  • This condition may be managed with medicine.
  • If medicines do not help relieve nausea and vomiting, you may need to receive fluids through an IV at the hospital.
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