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Thursday, May 2, 2019

Beyond morning sickness: hyperemesis gravidarum during pregnancy

by Dr. Jacqueline Kates

woman holding baby shoes on pregnant bellyMother’s Day is just around the corner, but so, too, is a lesser-known recognition day: HGAwareness Day on May 15. While we honor the women who gave us life, cared for and nurtured us, it’s also important to acknowledge that for many, pregnancy is not without its risks and challenges, such as morning sickness and its more serious cousin, hyperemesis gravidarum (HG).

Morning sickness

Morning sickness, typically consisting of nausea and vomiting, is a common occurrence in pregnancy, especially during the first trimester. However, up to three percent of pregnant women experience more severe symptoms called hyperemesis gravidarum.

Morning sickness is a catch-all term referring primarily to the nausea and vomiting many women experience while pregnant. It’s a bit of a misnomer because it affects all women differently and at different times of day, not just in the morning. Some women may vomit once a day and feel better right afterward; others may feel nauseated throughout the day, but never get sick.

HG is more serious—usually consisting of frequent vomiting accompanied by weight loss. It can make it extremely difficult to go about daily activities. In addition, the poor nutrition and dehydration can impact both the woman and the developing fetus.

HG treatment

We’re not sure what triggers HG in some women, so we can’t prevent it. That said, women who have it once are at increased risk of experiencing it again during future pregnancies. We have several treatment options, ranging from dietary changes and complimentary therapies to vitamin supplements and medications. In the most severe cases, women may need to be hospitalized for treatment.”

Depending on the severity of the symptoms, treatment for HG may include:

  • eating smaller and more frequent snacks;
  • drinking electrolyte-replacement beverages;
  • avoiding dietary and environmental triggers;
  • using supplements such as ginger;
  • taking a combination of vitamins, such as B6 with pyridoxine;
  • taking medications to reduce vomiting and acid reflux; and
  • receiving fluids with hydration or IV medications.

In rare cases, it may be necessary to use other methods to help with nutrition.

Left untreated, hyperemesis gravidarum can cause complications such as those related to malnutrition, in addition to other rare conditions related to repetitive vomiting that may affect multiple organ systems. HG can also be related to increased rate of preterm birth and infant low birth weight.

Talk to your provider about any symptoms you experience during pregnancy. Whether you have traditional morning sickness or more significant symptoms, we can offer advice, guidance and treatment to help you feel better. Symptoms are almost always temporary, but there is no reason for you to suffer unnecessarily or alone.