Pregnant women often experience a certain level of nausea and vomiting known as morning sickness. In general, this condition is not harmful and tends to resolve within the first twelve weeks of pregnancy. However, sometimes this morning sickness can be quite disturbing making the pregnancy unbearable.
Morning sickness and hyperemesis gravidarum are different medical conditions which have different side effects and possible complications for the pregnant women. It is very important to distinguish morning sickness and hyperemesis gravidarum.
While morning sickness is usually harmless for the pregnant women, hyperemesis gravidarum can be quite difficult leading to possible side effects and complications which can be even life – threatening for the developing fetus and even for the expecting mother.
What is hyperemesis gravidarum?Hyperemesis gravidarum is a condition affecting pregnant women, usually in the first few weeks of pregnancy. This condition is characterized by weight loss and electrolyte disturbance due to severe nausea and vomiting.
About 80% of pregnant women experience some type of morning sickness during their pregnancy and especially during the first trimester. However, in severe cases when morning sickness gets extreme, hyperemesis gravidarum develops.
Severe nausea is thought to result from increased levels of hormones, especially, the human chorionic gonadotropin (hCG). hCG is a hormone normally created during pregnancy from the placenta. Its levels tend to increase throughout the pregnancy.
Signs and symptoms of hyperemesis gravidarumCommon signs and symptoms of hyperemesis gravidarum are
• Severe nausea,
• Extreme fatigue,
• Food aversion,
• Weight loss,
• Decreased urination,
• Low blood pressure,
• Increased heart rate,
• Depression, etc.
When the signs and symptoms of hyperemesis gravidarum become noticeable?Hyperemesis gravidarum frequently starts to become noticeable between the fourth and sixth week of pregnancy. Nonetheless, it is believed that the peak of nausea and frequent vomiting reaches between the ninth and thirteenth week of pregnancy.
In about 20% of all cases with hyperemesis gravidarum, nausea, vomiting, and electrolyte disturbance occur throughout the pregnancy often requiring hospital treatment. Most of the pregnant women experience some relief between the fourteenth and twentieth week of pregnancy.
Risk factors for hyperemesis gravidarum include
• Hyperemesis gravidarum in a previous pregnancy,
• Being overweight,
• Being pregnant with twins or more fetuses,
• Being pregnant for the first time,
• Trophoblastic disease, etc.
Hyperemesis gravidarum can’t be prevented. However, this condition can be successfully managed, making the pregnancy an enjoyable period for the future mother.
How is hyperemesis gravidarum diagnosed?A complete medical history and physical examination are necessary when diagnosing hyperemesis gravidarum. Complete blood examinations, as well as, urinalysis are necessary to check for any signs of dehydration.
Ultrasound examinations are also important to check the progress of the pregnancy, the development of the fetus, as well as to discover the presence of a twin pregnancy or a development of a trophoblastic disease.
How is hyperemesis gravidarum treated?In mild to moderate cases bed rest followed by elimination of stress, good hydration, and a rich diet help relieve the signs and symptoms of hyperemesis gravidarum. You should try drinking constantly and eating smaller meals every couple of hours. Eating dry foods can also help a lot when dealing with hyperemesis gravidarum.
However, in severe cases of hyperemesis gravidarum intrahospital treatment is required. In a hospital, intravenous fluids are given in order to restore the hydration and provide a pregnant woman with all the necessary nutrients, vitamins and electrolytes very important for your own health and the health of your growing fetus inside of you.
In severe cases when even intravenous fluids don’t provide a relief of the signs and symptoms of hyperemesis gravidarum, tube feeding through nasogastric tubes or percutaneous endoscopic gastrostomy is required.
A nasogastric tube, consist in providing and restoring necessary nutrients, vitamins, and electrolytes through a tube which passes from the nose to the stomach. Percutaneous endoscopic gastrostomy is a surgical procedure which consists in restoring necessary nutrients, vitamins, and electrolytes through a tube directly inserted through the abdomen to the stomach.
Certain medications such as antireflux medications, metoclopramide or antihistamines are also recommended for the treatment of hyperemesis gravidarum.
Hyperemesis gravidarum resolves after giving birth. However, it has been estimated that the recovery period after childbirth is longer for those diagnosed with hyperemesis gravidarum during their pregnancy.
Paying attention to the emotional stress is also necessary, as hyperemesis gravidarum can interfere with your daily routine activities and life.