Every day, our nurses and attorneys receive calls from expectant mothers with concerns about symptoms they’re experiencing during their pregnancy. They’re curious if their symptoms are normal, and they wonder what their next steps should be. Patients should always visit a medical professional with concerns like these and receive appropriate care for maternal-fetal conditions and illnesses that can arise during pregnancy. We kickstarted the Pregnancy Spotlight Series, a monthly column that highlights specific pregnancy health concerns, to help educate and empower patients for these medical visits. Today, we’re focusing on Hyperemesis Gravidarum (HG).
What is hyperemesis gravidarum?
70-80% of all pregnant women experience some form of morning sickness during their pregnancy (1). Hyperemesis Gravidarum (hyper-, meaning “excessive,” emesis, meaning “vomiting” and gravidarum, meaning “pregnant woman”) (2) is a condition which involves extreme morning sickness, including nausea, vomiting, and weight loss as its major symptoms. It is thought to be a result of high levels of pregnancy hormones, but the exact cause is not known at this time (1).
What does hyperemesis gravidarum look like?
Hyperemesis gravidarum resembles common morning sickness, but is far more severe and often extends past the first trimester. So how is hyperemesis gravidarum different from regular morning sickness?
The following are symptoms of HG (1):
- Nausea that does not subside
- Severe vomiting
- Dehydration (caused by vomiting)
- Food aversions
- Low blood pressure
- Rapid heart rate
- Loss of 5% or more of pre-pregnancy weight
- Loss of skin elasticity due to dehydration
- Decreased urination
How long does HG last?
Many women experience relief between 14 and 20 weeks of pregnancy, but some have symptoms throughout their entire pregnancy.
Are there certain risk factors for HG?
The following groups of women tend to have HG at higher rates (1, 3, 4):
- Overweight women
- Young moms
- First-time moms
- Female infant sex
- Women carrying multiples
- Women whose mothers had HG
- Women with endocrine imbalances
- Women with H. pylori infection
- Women with extreme emotional stress
How is hyperemesis gravidarum treated?
Treatments for HG include improved hydration, dietary changes, rest, acupressure/acupuncture, and medications (such as antihistamines or drugs to address reflux and nausea). It is very important to consult a doctor about possible interventions. Self-medication is especially risky because certain drugs can endanger a mother and/or affect fetal development (1, 3). Severe cases of HG require a hospital visit where the mother receives IV fluids. They may also necessitate the use of feeding tubes, whether percutaneous endoscopic gastrostomy or nasogastric ones (1).
Will hyperemesis harm the baby?
According to the Hyperemesis Education and Research (HER) Foundation, preliminary research has shown that babies born to mothers with HG often have normal outcomes (although there is a lack of long-term data). However, more severe cases of HG can put the baby at risk for certain health issues (5).
Delayed treatment of vomiting can cause dehydration, which has negative effects on the baby. Dehydration can lead to the following complications for your baby (1):
- Low amniotic fluid
- Neural tube defects
- Premature labor
- Inadequate production of breast milk
- Birth defects
Will hyperemesis harm me?
Women with HG during pregnancy may deal with health problems such as electrolyte imbalances, depression, and other health concerns. They may also experience symptoms after pregnancy, including muscle weakness, motion sickness, and posttraumatic stress disorder (3).
1) Hyperemesis Gravidarum: Signs, Symptoms and Treatment. (2018, July 27). Retrieved November 9. 2018, from http://americanpregnancy.org/pregnancy-complications/hyperemesis-gravidarum/
2) WhattoExpect. (2018, October 12). Hyperemesis Gravidarum. Retrieved November 9, 2018, from https://www.whattoexpect.com/pregnancy/pregnancy-health/complications/hyperemesis-gravidarum.aspx
3) McCarthy, F. P., Lutomski, J. E., & Greene, R. A. (2014). Hyperemesis gravidarum: current perspectives. International journal of women’s health, 6, 719.
4) Hyperemesis Gravidarum: Causes, Symptoms, and Diagnosis. (n.d.). Retrieved November 9, 2018, from https://www.healthline.com/health/hyperemesis-gravidarum
5) Potential Fetal Complications. (n.d.). Retrieved November 9, 2018, from http://www.hyperemesis.org/hyperemesis-gravidarum/complications/fetal-programming.php
The information presented above is intended only to be a general educational resource. It is not intended to be (and should not be interpreted as) medical advice. If you have questions about the topic, please consult with a medical professional.