Hyperemesis Gravidarum


What is this?

This is a condition of excessive vomiting in pregnancy.
What causes it?

The causes are thought to be the same as those which cause Morning sickness but it is not clear why some women are so badly affected. Hyperemesis usually passes by12 -16 weeks, but sometimes continues beyond this time. 

How will I know if I've got it?

Unlike morning sickness, the nausea and vomiting of hyperemesis are usually relentless, going on all day and night. If you are vomitingconstantly, to the point where you have not eaten anything at all for more than 24 hours and cannot even tolerate sips of water or other fluids, you should phone your maternity unit for advice. Hyperemesis does not cause diarrhoea, so if you have this, it may be a bugor food poisoning. 

Is it dangerous? 

If excessive vomiting continues without treatment, it can be serious, and can eventually damage the kidneys, liver and even the heart, so if you are concerned about your condition, phone your maternity unit for advice. If you have hyperemesis, you will need to be admitted to hospital initially so that your condition can be monitored and treated appropriately.

It is important that you do not become dehydrated or deficient in certain vitamins and other nutrients. If you are very dehydrated, your urine output will decrease considerably, it will be dark in colour and may have a strange smell. You may feel cold, have a headache and even have blurred vision. The repeated vomiting can cause trauma to the oesophagus and you may vomit up blood. This damage will repair itself quickly once the vomiting stops.

Will it harm my baby?

Unless the excessive vomiting continues untreated, or you are already malnourished at the start of your pregnancy [this is unlikely unless you have an eating disorder or other pre-existing health problem], your baby should be able to absorb the nourishment it needs from your system. Once you have been admitted to hospital, the effects of dehydration and electrolyte imbalance can be quickly corrected by intravenous fluids until you are able to drink and eat again.

Is there anything I can do about it?

There are many theories about the causes of vomiting in pregnancy, and just as many different suggestions for treating it. Some of these are merely old wives tales and others may actually be harmful, so always seek the advice of a midwife or doctor before trying any remedies. Likewise, some complementary therapies such as homeopathy, reflexology or acupuncture can be very helpful, but make sure you attend a practitioner who is fully qualified and experienced in treating pregnant women.

The following suggestions are safe, but may only work for some women and not for others:

  • If you feel nauseous on waking, keep a drink by the bedside to have before you get up. Something like apple juice is ideal, as it is quite sweet and not too acidic if you do get sick later.
  • Get up slowly. Try to avoid bending and making sudden movements.
  • Try to identify and avoid random triggers which affect you.
  • Always try to eat a little bit of food in the morning it may not be something that you would usually eat for breakfast, and it doesnt have to be much, just enough to settle your stomach.
  • Avoid peaks and dips in blood glucose levels. This may mean having small, frequent snacks, rather than full meals. Try to chose foods which will give a steady release of carbohydrate if you snack on biscuits and other sugary foods, they may make you feel better initially, but will make you feel worse again as your blood sugar level drops.
  • Travel bands usuallyworn on the wrist to prevent sea-sickness, can help when placed correctly over a particular acupressure point.
  • Morningwell is available to download to your ipod. Listening to the carefully selected rhythmical beats through headphones can interrupt the signal between the gut and the ears, thus preventing your brain from thinking you have motion sickness. This is well researched and has been trialled within the NHS with good results.
  • Anti-emetics if none of the above suggestions help, and your condition is deteriorating, you should contact your maternity unit. There are several prescription medications available which can stop you being sick. These can be given as a tablet, but if you are vomiting continuously they are more likely to be given as a suppository or an injection. If you are in hospital they may be given intravenously.