WHAT IS HYPEREMESIS GRAVIDARUM

By Katie Roebuck

January 8, 2019

I am the mother of two children, an RN, Prenatal Educator, Lactation Counsellor, and Sleep Coach. My nursing career has been focused on Maternity and Obstetrics. I am based in the Niagara Region and I enjoy helping moms reach their goals with pregnancy and motherhood!

Most women know the early signs of pregnancy – missed menstrual cycle, sore breasts, and morning sickness. Approximately 70-80% of women will experience nausea and vomiting in their pregnancy. However, up to 2% of pregnant women know the difference of normal pregnancy related nausea and morning sickness, and Hyperemesis Gravidarum.

Hyperemesis Gravidarum isn’t just morning sickness, it’s much much worse. It can become so severe it causes weight loss and electrolyte and nutritional deficiencies in the mama. It’s serious and can be dangerous for both mama and baby if not managed properly, and may require hospitalization. Severe or prolonged Hyperemesis may increase the chances of having a smaller or underweight baby, or even a pre-term birth.

What Causes HYPEREMESIS GRAVIDARUM?

There is no real clear cause for Morning Sickness and Hyperemesis Gravidarum in pregnancy, so it is believed that there are multiple potential causes. Hormones, slowing of the digestive system, family history, high fat diet, and multiple gestation pregnancy (ie. twins or triplets), are some of the potential causes of Hyperemesis Gravidarum. If you had Hyperemesis in a previous pregnancy, you are more likely to have it again in a subsequent pregnancy but it’s not guaranteed.

Majority of nausea in pregnancy is mild to moderate and can be managed with small dietary and life habit changes, and potentially anti-nausea medications prescribed by your healthcare provider or obstetrician. The nausea will typically dissipate at the end of the first trimester.

How is Hyperemesis Gravidarum Diagnosed?

Severe or extreme nausea and vomiting as in Hyperemesis Gravidarum require more extensive treatment. Hyperemesis Gravidarum is defined as:

  • Extreme, excessive, and persistent vomiting
  • Weight loss of 5% or more of your pre-pregnancy weight
  • Fluid, electrolyte, and nutrition levels become unbalanced

Diagnoses is made by your Obstetrician or Midwife, usually with blood work and urine tests to confirm the severity of the fluid and electrolyte defects, and an ultrasound to check on baby’s health.

Hyperemesis may require hospitalization for intravenous (IV) re-hydration and medications to help control the nausea. In extreme situations, mamas may receive nutrition through a tube down their nose or through an IV until the Hyperemesis can be brought under control.

Most of the time Hyperemesis Gravidarum will dissipate by the middle of your pregnancy, around 20 weeks, however some women continue to experience Hyperemesis Gravidarum throughout their entire pregnancy.

What are the signs of Hyperemesis Gravidarum?

Signs of Hyperemesis Gravidarum are typically the following. If you are pregnant and have these symptoms, you should be assessed by your prenatal care provider.

  • Dark, amber coloured urine
  • Not urinating as often as before
  • Dizzyness when standing up
  • Vomiting repeatedly throughout the day
  • Blood in your vomit
  • Abdominal or pelvic pain or cramping
  • Unable to keep any food or drinks down for over 12 hrs
  • Weight loss of more then 3kg (6.6lbs) or 5% of your pre-pregnancy weight

Other then the risk of your baby being smaller then the average or the risk of a pre-term birth, there does not seem to be any long term risk to your baby. Once your Hyperemesis Gravidarum is managed or has passed, try to maintain a balanced healthy diet to keep your nutritional levels up.

Hyperemesis can also have an impact on your mental health. Having a village of support, as well as professionals to talk to, can make a big difference in your management of Hyperemesis.

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