Hyperemesis Gravidarum: Severe Nausea During Pregnancy

Nausea and vomiting can be among the early signs and symptoms of pregnancy. However, if these symptoms are severe, this could indicate a condition called hyperemesis gravidarum, which is often described as an intense form of morning sickness and can require medical treatment. Read on to learn more about this condition — including the differences between hyperemesis gravidarum and regular morning sickness — and how to manage it. You can also check out one mom’s personal experience with hyperemesis gravidarum and the treatments she received during three pregnancies.

What Is Hyperemesis Gravidarum?

Hyperemesis gravidarum is a severe form of nausea and vomiting. When you vomit a lot, you lose fluids in your body, and this dehydration can affect your electrolyte levels and disrupt your kidney function. In fact, with severe vomiting, you may lose more than 5 percent of your body weight. If left untreated, severe weight loss can affect your baby’s birth weight and potentially lead to preterm birth. With hyperemesis gravidarum, nausea can last for several hours each day and can severely impact your daily life. This condition requires treatment from your healthcare provider to control the vomiting and to restore the fluids you need to stay healthy.

Although up to 85 percent of moms-to-be experience some degree of morning sickness during pregnancy, hyperemesis gravidarum only affects about 3 percent of pregnant women. It usually strikes in early pregnancy, before about nine weeks, and often goes away during the second trimester. 

Symptoms of Hyperemesis Gravidarum

Common signs of hyperemesis gravidarum include: experiencing nausea that lasts more than a few hours every day, vomiting more than three times a day, and these symptoms interfering with your daily life.

This extreme nausea and vomiting can have other consequences, including:

• Dehydration. If you're dehydrated, you might notice your mouth and skin are dry and that you're urinating fewer than three times each day. Dark-coloured urine is another common symptom of dehydration. Try to drink fluids like water or ginger ale during periods when you're not feeling nauseated.
• Dizziness. Feeling lightheaded can also indicate hyperemesis gravidarum.
• Weight loss. Losing more than about five pounds in two weeks can be cause for concern.
• Dental problems. If you're vomiting frequently, your stomach acids can gradually wear away at the enamel on your teeth, leaving you more vulnerable to infections and other dental problems. Rinsing your mouth with a teaspoon of baking soda in water can help safeguard your enamel after vomiting. Your dentist can give you more advice on preventing damage to your teeth.

These symptoms are among the warning signs you should not ignore when you're pregnant. If you notice any of the symptoms described here, or if you suspect you may have hyperemesis gravidarum, contact your healthcare provider.

Hyperemesis Gravidarum vs. Morning Sickness

You might be wondering whether you’re experiencing morning sickness or hyperemesis gravidarum. Your healthcare provider is the only one who can diagnose what you have, but here are some of the differences between the two conditions:

Causes and Risk Factors

Hyperemesis gravidarum may be triggered by hormonal changes during pregnancy such as increases in your hCG and estrogen levels. It might also be more likely to strike if you’re carrying twins or more. In rare cases, it may be due to an underlying condition like a thyroid or liver disorder.

If your mother or sister experienced hyperemesis gravidarum during their pregnancies, it’s possible you will, too, as this disorder has a tendency to run in families. Also, although you probably don’t know your baby’s gender yet, hyperemesis gravidarum is more likely to occur if you’re carrying a girl.

Hyperemesis Gravidarum Prevention and Treatment

Unfortunately, there are no foolproof ways to prevent hyperemesis gravidarum. Treatment options may range from home remedies to medical care at a hospital, depending on the severity of your symptoms and what your healthcare provider thinks is right for your situation.

To combat nausea at home, your provider may first suggest that you try to avoid those odors and flavors that seem to trigger it. Other strategies your provider may recommend include:

• Sticking to a bland diet of foods like bananas, rice, or toast
• Taking a vitamin B6 supplement (alongside other prenatal vitamins)
• Drinking ginger tea
• Wearing a pressure point wristband. These wristbands provide acupressure, and they’re often used to help with motion or seasickness. Although these products are not scientifically proven to treat nausea, many moms-to-be believe that they provide some relief.

Depending on how ill you are, these home remedies alone might not be effective, and you may need further medical treatment. If you’ve been losing a lot of weight or vomiting frequently, your healthcare provider may admit you to a hospital, where treatment options might include:

• Replenishing your fluids and vitamins via an IV drip
• Taking prescription medications that help control the vomiting and nausea caused by hyperemesis gravidarum
• In extreme cases, if your weight loss is a concern, being given a feeding tube to make sure you and your baby are both getting enough nutrients.

FREQUENTLY ASKED QUESTIONS

• How long does hyperemesis gravidarum last?

Hyperemesis gravidarum can start around week nine and can last several weeks or months, before easing in the second trimester.

• Is there any medication I can take for hyperemesis gravidarum?

Your healthcare provider may prescribe anti-nausea medication to treat your hyperemesis gravidarum. Just don’t take any medications without first talking to your provider.

• Will I have hyperemesis gravidarum during my next pregnancy, too?

Having had hyperemesis gravidarum before is a risk factor for having this in future pregnancies. Of course, it’s not a sure thing.

Having hyperemesis gravidarum is tough, no doubt about it. Try to keep in mind that your healthcare provider will help you find a way to get through it. Believe it or not, the nausea and vomiting will probably pass as you get into the second trimester. Hang in there — you're almost there.