Hyperemesis gravidarum during pregnancy

The exact cause of hyperemesis gravidarum is not known, but medical practitioners and researchers have proposed different theories for it.

• Scientists believe that this rare condition may be caused by endocrine (hormonal) factors, infections, psychosocial factors, and hereditary factors.
• Doctors have also proposed hormonal imbalance during pregnancy, vitamin B deficiency, transient hyperthyroidism (that is, the patient did not have hyperthyroidism before pregnancy), Helicobacter Pylori infection and improper carbohydrate metabolism as potential causes.
• Some doctors believe that gastroesophageal reflux (acidity) along with irregular electrical impulse of muscles of the stomach, medically known as gastric dysrhythmias, leads to hyperemesis in pregnant women.
• Studies have found that the cause of hyperemesis could be genetic as well: a pregnant woman with a family history of hyperemesis has a threefold chance of getting the condition.

In addition to nausea and excessive vomiting, the other symptoms of hyperemesis gravidarum are:

• Dehydration
• Dizziness
• Low blood pressure (hypotension)
• Increased heart rate (tachycardia)
• Dry skin
• Weight loss
• Headache
• Decreased urination
• Mood swings
• Lethargy

Go to the hospital if you notice these symptoms in addition to excessive nausea and vomiting and/or weight loss.

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The treatment depends upon the severity of the condition. 

• Diet: The doctor may advise the patient to make some modifications in her diet which could help in relieving nausea. The meals should contain more carbohydrates and proteins than fats. The doctor may prescribe some lighter snacks like nuts and some dairy products to help relieve the symptoms. Drinks like coconut water are usually prescribed to boost the electrolytes. 
• Intravenous fluids: Intravenous (IV) fluids could be given to pregnant women with more severe symptoms who are unable to ingest anything orally. This is done to restore hydration, electrolytes, vitamins, and nutrients.
• Feeding tube: In some cases, doctors may also use a nasogastric feeding tube to restore nutrients through a tube passing through the nose and into the stomach.
• Medicines: Anti-emetics (anti-vomiting tablets like promethazine and meclizine), antihistamines, and antireflux medications could be given by the doctor. Please remember that no medication should be taken by the pregnant woman without a prescription.
• Home remedies: Foods like ginger may be effective in reducing the symptoms of hyperemesis in some women. This is because of the aromatic and carminative characteristics (reduce flatulence) of ginger.

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Morning sickness and hyperemesis gravidarum have similar symptoms, but the intensity and remedies are very different. Here’s how you can tell them apart.

First, the common signs of morning sickness:

• Nausea, often called morning sickness, is very common among pregnant women during the first trimester of pregnancy. 
• Irrespective of the name, morning sickness can occur at any time of the day and is not always accompanied by vomiting.
• Morning sickness is unpleasant but does not cause any harm to either the mother or the foetus.
• It resolves on its own sometime between week 12 and week 16 of pregnancy.

Hyperemesis gravidarum has the following symptoms:

• Extreme nausea and vomiting.
• The affected women will not just feel nauseous but also have severe vomiting with ptyalism (excessive salivation).
• Hyperemesis can cause severe dehydration, electrolytic imbalance, ketonuria (ketone bodies in urine), muscle wasting, weight loss (more than 5% of pre-pregnancy weight) and acidosis due to starvation.
• Vomiting associated with hyperemesis might resolve at 20 weeks of pregnancy, but it requires immediate medical attention to counter the effects.

Read more: Home remedies for nausea and vomiting