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HYPEREMESIS GRAVIDARUM
What is hyperemesis?
Many women experience nausea and vomiting during their first trimester and sometimes into their second trimester due to hormonal changes brought on by the pregnancy. In some instances, the "morning sickness" will be so severe that weight loss and severe dehydration occurs which is then called hyperemesis.
How can hyperemesis affect me?
In a time when most women are counting the pounds that they have gained, women with hyperemesis will struggle to maintain their pre-pregnancy weight and usually lose as much as 5% of their pre-pregnancy weight during the first trimester. As a result of the weight loss, a condition called ketosis can develop which will prevent the proper absorption of nutrients and fats. This can also result in an electrolyte imbalance from the lack of salt absorption into the blood stream. Women with severe hyperemesis will feel extremely tired and begin to lose muscle mass.
How do I know if my morning sickness is hyperemesis?
Signs that you should alert your doctor to are the following:
- Inability to keep any fluids down in a 24-hour period.
- Weight loss of 5 or more pounds
- Infrequent urination
- Extreme tiredness and/or weakness
- Your doctor may run tests to determine the level of ketones in your urine (indicates ketosis) and to check for an electrolyte imbalance.
What can be done for hyperemesis?
The most important task to reverse the effects of hyperemesis is to keep fluids and nutrients down. Your doctor may do one or more of the following:
- Order an IV to replace fluids directly into your blood stream (rehydrate).
- Order medication like Phenergan (Promethazine), or Reglan to alleviate nausea and vomiting.
- Hospitalization may be required for treatment.
Alternative Relief
A recent study was conducted to determine the effectiveness of ginger for the treatment of nausea and vomiting in pregnancy. Ginger, known scientifically as Zingiber officinale, is a perennial native to many Asian countries. It is widely cultivated for its aromatic rhizome, which can be used as a spice to enhance the flavor of foods and beverages. Ginger is also valued as a herbal medicine for the relief of gastrointestinal distress. In Thailand, ginger has long been recommended as as folklore treatment for nausea and vomiting of pregnancy.
The results of the study showed that there was a significantly greater reduction in nausea and vomiting scores in the women given ginger. Twenty eight of the thirty-two ginger-treated women reported that their symptoms improved. The study concluded that ginger is effective for relieving the severity of nausea and vomiting in pregnancy.
How will it affect the growth and development of my baby?
Hyperemesis is fairly rare and in only a few cases of those women who develop severe vomiting, does it endanger the life of the mother and the fetus. In cases where nutrient depletion is so great that it may threaten the fetus, a procedure called IV hyper-alimentation may be performed. This procedure adds nutrients directly into the blood stream and allows the mothers gastrointestinal tract to rest.
The most important way to protect the development of your baby is to always keep your doctor informed of your symptoms. Call your doctor immediately if you experience any of the symptoms listed above.
Susan Glander, MD, FACOG
Dr. Glander is in private practice in Atlanta, Georgia.
Date Published: 2001-11-28
7800 Wolf Trail Cove, Germantown, TN 38138
Phone: (901) 682-9222; Fax: (901) 682-9505