What is hyperemesis gravidarum?
Hyperemesis gravidarum, or HG, is an uncommon condition that is much more severe than normal pregnancy sickness. It is a severe form of nausea and vomiting in pregnancy (NVP).
It can be so severe that a woman becomes dehydrated, loses weight and may have to be admitted to hospital and treated with intravenous fluids under specialist care.
Hyperemesis gravidarum affects around 1 to 3 in every 100 pregnant women.
What are the symptoms of hyperemesis gravidarum?
The symptoms of hyperemesis gravidarum go far beyond the discomfort of morning sickness and require urgent medical attention. They include:
- Prolonged and severe nausea and vomiting
- Dehydration caused by the vomiting
- Ketosis - raised levels of toxic acidic chemicals in the blood called ketones
- Losing weight due to inability to keep food down
- Low blood pressure, known as hypotension, especially on standing up
- Risk of DVT - deep vein thrombosis (blood clots in a vein) - due to dehydration.
In terms of the quality of life, HG can affect a woman’s work, home life and her ability to care for her family due to frequent vomiting - or trying to vomit because there’s nothing in the stomach so she can’t vomit, and retches instead.
It’s been described by some women as like having your stomach turned inside out, it’s so severe. It can last for many weeks, sometimes throughout pregnancy.
Although support from family and friends can help, the Royal College of Obstetricians and Gynaecologists (RCOG) recognises that symptoms can sometimes be so severe that women may become depressed and need extra support, such as counselling. It recommends that a pregnant woman who persistently 'feels down' should speak to their healthcare professional.
Is there any risk that hyperemesis gravidarum can cause a woman to lose her baby?
Experts at the RCOG say hyperemesis gravidarum is unlikely to cause harm to an unborn baby.
In fact, you may have a slightly lower risk of miscarriage than women who do not have the condition.
However, left untreated, weight loss during pregnancy may lead to a baby having a low birth weight and you may be offered extra scans to monitor the growth of your baby.
Is there anything that pregnant women can do themselves to lessen the symptoms?
Experts suggest trying to move less, avoiding tasks such as cleaning the house may help, as any movement may make the feeling of nausea worse.
Rest and relaxation may be recommended as well as avoiding some smells, including food or cooking odours.
Further advice is to eat small amounts often. Meals that are high in carbohydrate and low in fat, such as potato, rice and pasta, are easier to tolerate. Biscuits or crackers may also be easier to digest.
Some women find that eating or drinking ginger products helps. However, be aware that these may sometimes irritate your stomach.
Complementary therapies such as acupressure or acupuncture may also be helpful.
What if my symptoms don't resolve themselves?
If your symptoms do not settle or if they prevent you doing your day-to-day activities, you should make an appointment to see your GP. He or she may prescribe anti-sickness medication which is safe to take in pregnancy.
Your GP or midwife may arrange for you to be seen in the assessment unit at your hospital.