Hyperemesis Gravidarum

Most women experience some form of morning sickness during their pregnancy, especially between the 5th and 12th weeks. However, about 1 percent of pregnant women experience severe nausea and vomiting, a condition called hyperemesis gravidarum. While normal morning sickness is thought to be caused by rising hormone levels, the precise cause of hyperemesis gravidarum is unknown.

Hyperemesis gravidarum, or HG, is characterized by severe nausea, vomiting, weight loss, and electrolyte disturbance. Women who suffer from this condition may experience dehydration, headaches, confusion, rapid heart rate, and fainting; and may be unable to work, complete usual daily tasks, or maintain a normal social routine. Left untreated, severe cases of HG can cause significant health problems for you and your baby. Acid-based disturbances caused by malnutrition and dehydration can lead to kidney and liver injury, persistent vomiting can lead to esophageal tears, and nutritional deficiencies can lead to neurological changes. Risks to the baby include premature birth, low birth weight, and a slight increase in malformation of the central nervous system and skin.

HG is usually diagnosed by ruling out any other cause of severe nausea and vomiting such as pancreatitis, hepatitis, peptic ulcer disease, and hyperthyroidism. Your doctor will take a full medical history, perform a thorough clinical evaluation, and identify your symptoms.

How to tell the difference between HG and normal morning sickness:

Morning Sickness	Hyperemesis Gravidarum
Nausea sometimes accompanied by vomiting	Nausea accompanied by severe vomiting
Nausea that subsides at 12 weeks or soon thereafter	Nausea that continues past the first trimester (13 weeks)
Vomiting that does not cause severe dehydration	Vomiting that causes severe dehydration
You are able to keep some food down	You cannot keep any food down

If you are diagnosed with HG, you will most likely be hospitalized immediately to restore fluids and replace electrolytes intravenously. You may also receive vitamin supplements, especially vitamins B6, C, and thiamine. You should not consume food orally until the vomiting stops and dehydration has been corrected; if vomiting persists, you may be given antiemetic (anti-nausea and vomiting) drug therapy.

Studies performed to determine the cause of HG have been inconclusive. It is thought that estrogen, progesterone, adrenal, and pituitary hormones all play a part. Psychological and social factors also seem to have a connection. For example, women who are having an unwanted pregnancy; or young, unwed mothers who feel harassed by their parents for their "mistake" seem to have a higher incidence of HG. The disease is also more common among women with a higher body weight, no previous completed pregnancies, those who are carrying twins, first-time pregnancies, and those with a history of HG in previous pregnancies. It is becoming clear that HG is a complex physiological disease probably caused by multiple factors.

Acupressure and hypnosis has been shown to help some women suffering from HG. The pressure point to reduce nausea is located at the middle of the inner wrist and applying pressure to this point may help some HG sufferers. Seabands that use this pressure point can be purchased at many drug stores.

The HER Foundation, or Hyperemesis Education & Research Foundation, provides education and support for mothers suffering from HG and those who care for them. You can contact them on the Web at www.helpher.org