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Christian Hoffman, MD

Hyperemesis Gravidarum

Suffering from severe morning sickness? Here's how to spot the signs of hyperemesis gravidarum and how to treat it safely.

What is hyperemesis gravidarum?

Just about every pregnant woman knows what it’s like to be nauseated during her nine-month journey (though there are the lucky few who escape morning sickness altogether—go ahead and secretly hate them). But for some women, morning sickness becomes a severe condition that requires medical attention. Hyperemesis gravidarum is defined as extreme, persistent  nausea and vomiting, which can land you in the hospital with dehydration. Symptoms sometimes don’t let up after the first trimester and can stick with you the whole darn pregnancy.

What are the signs of hyperemesis gravidarum?

There’s nausea...and then there’s nausea. With hyperemesis gravidarum, the nausea and vomiting are so severe you can become dehydrated and, over time, may even lose some body weight while baby increases his or hers. Other signs are extreme fatigue, fainting, headaches, decrease in urination, low blood pressure and rapid heart rate.
Are there any tests for hyperemesis gravidarum?

A physical exam (low blood pressure, high pulse rate) can help clue in your doctor as to whether you’ve crossed the line from morning sickness to hyperemesis gravidarum. In addition, he or she may run some blood and urine tests to check for signs of dehydration. 

How common is hyperemesis gravidarum?

While up to 80 percent of pregnant women develop some level of morning sickness, at least 60,000 cases are severe enough to be considered hyperemesis gravidarum. (Although, since many cases may be unreported, the actual numbers may be even higher.)

How did I get hyperemesis gravidarum?

There’s some evidence that the severe nausea can be blamed on rising levels of the hormone HCB (human chorionic gonadotropoin), but the exact cause of hyperemesis gravidarum is still unknown. Moms who are pregnant with multiples are at increased risk. If you’re having a molar pregnancy, you may also have these symptoms.

How will hyperemesis gravidarum affect my baby?

Luckily, while you might feel like hell, chances are your baby is continuing to grow without any problems. However, if you don’t get enough nutrition or hydration for a significant amount of time, it can affect your baby’s birth weight and development (see next page for treatment, prevention, advice and resources).

What’s the best way to treat hyperemesis gravidarum?

Try modifying your diet to have small, frequent meals (an empty stomach can sometimes trigger more nausea), avoiding fatty foods and drinking plenty of fluids to help prevent dehydration. If that still doesn’t help, your doctor may suggest taking the vitamin B6, which in some cases has been shown to decrease nausea in pregnancy, or even certain anti-nausea prescription medications.

What can I do to prevent hyperemesis gravidarum?

Unfortunately, there’s not much, if anything, you can do to prevent hyperemesis gravidarum. But the good news is that while it’s sheer misery when you’re in the midst of it, this is one condition that definitely goes away the moment your baby is born.

What do other pregnant moms do when they have hyperemesis gravidarum?

“I had this with my first, and it was significantly worse with my second. I was hospitalized and on home health care with IVs and a Zofran pump for several months. We are currently planning TTC our third, and I am terrified of going through it again.”

“I have had it both pregnancies, but mine was and still is manageable. They almost sent me home with an IV about 12 weeks or so, but things got better, so I did not end up with that route. I have a friend that was so bad that she needed the IV and nurse care at home for quite some time.”

“I was on three different medications that I injected into my IV line that I had all the time. I had a backpack IV bag so I could leave the house with my IV pole. Unfortunately, there wasn’t that much that helped me and I was sick until I delivered.”
Are there any other resources for hyperemesis gravidarum?  
HER (Hyperemesis Education & Research) Foundation

Plus, more from The Bump:

Morning Sickness

Nausea During Pregnancy

Sick of Being Sick?

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