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Beyond morning sickness: what is hyperemesis gravidarum?

We often focus on pregnancy being a happy time in a woman’s life, talking up the joyful expectations and healthy glow. But the hormonal changes that come with it can also make it a stressful period of physical discomfort and emotional challenges. Any woman who’s suffered from morning sickness can attest to that – and there are a lot of them.

Around 7 in 10 women experience this nausea and vomiting and, contrary to the name, it is not always restricted to the early hours of the day.

However, while it can be unpleasant and tiring, morning sickness generally clears up by around 14 weeks.

For a smaller number of women, this sickness takes on a more extreme form. Roughly 1 in 100 women will have to deal with hyperemesis gravidarum (HG).

What does the condition involve?

With HG, nausea is persistent and excessive, often greatly affecting a woman’s daily life. You may vomit frequently and find it extremely difficult to keep food down. This, in turn, means you are at risk of becoming dehydrated.

HG may also not get better by 14 weeks and persist somewhat until the baby is born, although some symptoms may improve around 20 weeks in. If symptoms are severe, please seek medical advice from your GP.

What causes HG?

It is not known exactly why some women have to deal with HG, though it has been shown to run in families. So, if your mother or sister has had HG, you are more likely to face it. If you have had HG in a previous pregnancy, the chances are that it will also affect you in your next. When this is the case, some pre-planning can lessen its impact – your doctor may agree to put you on suitable medication early, for example.

What symptoms should I watch out for?

  • Severe and prolonged nausea and vomiting
  • Dehydration
  • Weight loss
  • Ketosis – where the body does not have enough glucose and burns stored fats instead
  • Low blood pressure when standing

Other, less common symptoms include a heightened sense of smell, excessive saliva production and episodes of urinary incontinence.

The persistent and debilitating nature of HG can also impact your emotional wellbeing. You may feel anxious about leaving the house, as you are unsure when the next wave of nausea will strike. If your mental health is affected, it’s helpful to talk to your midwife and doctor. Sharing your concerns with your family and friends may also bring some comfort and relief.

Can HG harm my baby?

HG is unlikely to affect your baby’s health – once it is properly treated. If you lose weight, this can result in a lower birth weight and have a significant impact on your baby’s health. Seek medical advice to ensure your baby’s development is not adversely affected.

How can I treat HG?

You should see your GP or midwife before dehydration becomes a problem. Once HG is diagnosed, there are medications that can be used to alleviate symptoms, including anti-sickness (antiemetic) drugs and vitamins (B6 and B12).

There are some other things you can do that may minimise sickness:

  • Eat small snacks regularly, rather than big meals
  • Keep meals bland and cool – strong smells and hot food can trigger nausea
  • Drink plenty of water and herbal teas and eat fruit to keep fluids up

When symptoms cannot be brought under control, a hospital stay will be required so fluids can be given intravenously through a drip. Vitamins and minerals will also be replaced to return you to full health.

Once you have taken these proactive steps to protecting your health, try to remember that your HG will completely clear up once you have given birth.

If you found this article useful, visit the Health Hub for more on maternity issues.