Hyperemesis Gravidarum: Causes, Symptoms & Latest Management Protocols

 Hyperemesis Gravidarum: What It Is, The Symptoms It's Causing, And How To Deal With It.

Disclaimer! 

The information provided in this article is solely for educational or informational purposes, and is not meant to replace professional (personalized) medical advice, diagnosis or treatment. Always consult a qualified healthcare professional before making any decisions regarding your healthcare.

Author!

Dr Humaira Latif 

Registered Medical Practitioner ,Gynae/Obs specialist.Experience 14 plus years in clinical and health field.Medical & Health Content Creator.

1.What Is Hyperemesis Gravidarum?

Hyperemesis gravidarum (HG) is the medical term for an extreme form of morning sickness during pregnancy, characterized by severe, persistent nausea and vomiting that lasts for longer than typical morning sickness. Most women experience a mild to moderate amount of nausea during the first trimester of their pregnancies. However, for a woman with HG, the symptoms are so severe that they can prevent her from being able to eat, drink and perform daily activities. 

Unlike regular morning sickness that typically goes away by the end of the first trimester, hyperemesis gravidarum generally develops by 6 weeks of gestation and lasts several months, unless properly treated. 

Approximately 0.5 % to 2 % of all pregnancies will experience HG; typically, women will start to have symptoms at approximately 6 weeks and peak around 9-12 weeks and (in some cases) may have symptoms that continue after the first trimester. 

Getting to know hyperemesis gravidarum early on will allow you to identify early warning signs and seek timely treatment, as well as help you manage your symptoms effectively, in conjunction with the rest of your health care team.

2.Hyperemesis Gravidarum- (HG) is Not Well Understood

Doctors have not been able to determine exactly why some women develop HG; however, there are many variables known or thought to cause HG. Some possible causes include the following:

2.1 Hormonal Changes.

Pregnancy hormones (human chorionic gonadotropin or hCG) generally rise rapidly early in pregnancy and peak at about 11 weeks into the pregnancy. Fluctuations in estrogen may also cause nausea and vomiting.

2.2 Family History.

Women with a family history of hyperemesis gravidarum or women who have experienced hyperemesis gravidarum in a previous pregnancy are more likely to develop HG.

2.3 Sensitivity to Hormones.

Some studies suggest a higher sensitivity to hCG or other metabolism-related hormones may be related to HG symptom severity.

2.4 Other Factors.

Although not substantiated, some metabolic differences, nutrient deficiencies, or diseased thyroids or livers could be related to the more severe symptoms of HG. 

While there is currently no clearly defined cause, it is likely that HG results from a combination of the patient’s medical, physical, and genetic makeup.

3.Identifying Symptoms.

It is important to be able to identify hyperemesis gravidarum (HG) as the symptoms will be much more severe than regular pregnancy nausea and include the following:

3.1 Continuous Vomiting and Nausea.

Women experiencing HG may continuously vomit more than 3 to 4 times throughout the day, and have trouble keeping either food or fluids down.

3.2 Dehydration and decreased urine output.

Those that cannot retain fluids may develop dehydration; dehydration is generally identifiable (e.g., through dark urine and/or lower than normal amount of urine).

3.3 weight Loss.

As per clinical evidence, women with severe HD should show a weight loss of >5% from their initial pre-pregnancy weight.

3.4 Dizziness or Lightheadedness.

The symptoms of dizziness/lightheadedness may indicate dehydration or an electrolyte deficiency associated with continuous vomiting.

3.5 Extreme Fatigue and Weakness.

Consistent vomiting and a lack of nutrients can cause fatigue at a very high level.

4.Symptom.

Typical Symptoms are!

• Perpetual vomiting – Multiple times/day
• Dehydration – Decreased urination, dry mouth, dizziness
• Weight Loss >5%*
• Tiredness – Weak
• Dizziness – Lightheadedness or feeling faint

If your symptoms are preventing you from completing daily tasks, or theyˆare not improving after several days, it may be time for you to consult a professional for a medical assessment.

5.How Does Clinical Diagnosis Occur In Hyperemesis Gravidarum?

The doctor will review the patient's medical history, see the patient physically, perform laboratory tests and examine the measured weight gains of the mother-to-be.

• Blood tests may also be used to determine electrolyte levels, measure kidney and liver functions and verify that the woman is hydrated.
• Ketones in urine indicate dehydration and some degree of metabolic imbalances.
• Ultrasound may be performed to determine if the pregnancy is developing normally and to rule out other possibilities such as a multiple gestation or a prior spontaneous abortion.

Early diagnosis facilitates the provision of the proper treatment options, minimizes complications and improves the health of the mother.

6.How to Manage Care

How hyperemesis gravidarum is treated will depend on the severity of symptoms and might involve both lifestyle changes and medical treatments.

6.1 Home and Dietary Strategies

• Eat smaller and more frequent meals instead of having three regular-sized meals.
• Choose bland and easily digestible foods like crackers or toast.
• Try using ginger in tea or supplement form for nausea relief.
• Avoid strong food smells or triggers that may worsen feelings of nausea.

6.2 Medication

• A physician may prescribe anti-nausea medications.
• Vitamin B6 (pyridoxine) is frequently used to reduce nausea.
• IV fluids may be necessary when experiencing dehydration.

6.3 Hospital Care

• If a woman is severe enough not to be able to take in food orally, she may be hospitalized for IV fluids, electrolyte replacement, and antiemetic therapy.
• Working with a maternity provider will contribute to collaborative care that is tailored to meet a woman’s individual needs and to reduce maternal discomfort.

7.Women should see a doctor if they experience:

Early and continuous communication with your provider will help ensure women are managed safely and prevent complications from pregnancy and hyperemesis.

8.See Also

You can also find these educational materials helpful

1. Postpartum Nutrition for Severe Nausea: https://dryasirhumaira342.blogspot.com/

2. Managing Pregnancy Fatigue Safely: https://dryasirhumaira342.blogspot.com/

3. Balanced Nutrition Guidelines for a Pregnancy Diet: https://dryasirhumaira342.blogspot.com/

4. Recognizing Warning Signs Early in a Pregnancy: https://dryasirhumaira342.blogspot.com/

Reference Sources (Establishment of Knowledge)

1.Cleveland Clinic. An Overview of Hyperemesis Gravidarum (2023 updates).     

Cleveland Clinic.

2.Medline plus Medical Encyclopedia on HG (2022).     

Medline plus

3.MSD Manual on Hyperemesis Gravidarum: Professional Edition (Dec 2023).     

MSD Manual

4.Health line - Guide to Hyperemesis Gravidarum Symptoms and Treatment

 Health line.