What is hyperemesis gravidarum or severe morning sickness?

Pregnant woman lying down

Sickness during pregnancy is extremely common. According to the NHS* around seven out of ten women will experience nausea and vomiting. This is commonly known as morning sickness, although it can affect sufferers at any time of day. Regular morning sickness usually improves or disappears from around week 14.

Some women experience a far more severe form of pregnancy sickness known as hyperemesis gravidarum (HG), which can cause excessive nausea and vomiting many times a day and can have a major impact on women’s daily lives. HG can also be dangerous and require hospital treatment. The Duchess of Cambridge Kate Middleton is one high-profile sufferer. HG  symptoms generally improve around 21 weeks but can continue much longer.

It is not known exactly what causes either morning sickness or HG. There is some evidence that it runs in families and if you have had HG once, it is more likely that you will suffer it again in future pregnancies.

What are the symptoms of hyperemesis gravidarum?

Hyperemesis gravidarum is much worse than regular morning sickness but is still characterised by nausea and sickness. In the case of HG, this nausea and sickness is prolonged and severe, with some women reporting episodes of vomiting up to 50 times a day and being unable to keep any food or drink down.*

Other related symptoms could include:

  • Dehydration, especially if you are unable to keep drinks down
  • Weight loss
  • Low blood pressure (hypotension), especially on standing
  • Severe fatigue
  • Headaches and constipation from dehydration

HG can also lead to a condition known as ketosis. This occurs when your body breaks down fat rather than glucose for energy and can lead to a build-up of acidic chemicals in the blood and urine.

What treatments are available for HG?

If you suffer from severe sickness during pregnancy you should see your doctor or midwife who will be able to assess the severity of the condition and advise you on the best course of treatment. Sometimes it may be necessary to try different types of medication to find the treatment that works for you.

Some medications can be used in the first 12 weeks of pregnancy to help control the symptoms of HG. You will be tried on anti-emetic (anti-sickness) drugs which are considered safe in pregnancy and if one doesn’t work another can be tried.

If the sickness is not improving and you are becoming dehydrated you may need to be admitted to hospital, where you will be given fluids via a drip and medications to stop the vomiting which may include steroids and thiamine vitamins, as well as antiemetics. Your condition will be monitored by checking your blood pressure, pulse, weight, blood tests and urine.

What is the impact of severe pregnancy sickness?

HG itself will not harm your baby but if you lose a significant amount of weight during pregnancy there is a higher chance that your baby will have a low birth weight.

HG can also have a serious impact on your physical and mental health and emotional well-being, especially at a time when you might otherwise expect to be happy and excited. It can be exhausting and prevent you from getting on with everyday tasks. Some women also feel very isolated as they get anxious about leaving the home in case they vomit.

It’s important to talk to your midwife or doctor for advice if you are experiencing any of these symptoms.

Zika virus health warning for pregnant women

*source: www.nhs.uk

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