Glengarry Private Hospital
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Hyperemesis Gravidarum vs Morning Sickness

Nov 13, 2017

Nausea and vomiting are very common in pregnancy, particularly during the first trimester.

Around three-quarters of women are affected and about 80 per cent feel sick at varying times of the day — much to the dismay of many expectant mothers.
 
There is a light at the end of the tunnel for most, with morning sickness subsiding after week 12. But unfortunately for some, the vomiting and nausea is very severe and occurs multiple times every day. This is a condition called hyperemesis gravidarum. Symptoms usually improve between weeks 15 and 20, but for a small percentage of women they may persist through the entire pregnancy.

Hyperemesis gravidarum vs. morning sickness

Hyperemesis gravidarum is like morning sickness but far worse. It affects 0.3 to 2.3 per cent of pregnancies and it is persistent and severe nausea and vomiting. The effects can be far-reaching and beyond the physical. Many women feel great distress and sometimes depressed, and there is a heavy impact on their social and work life, as well as a risk of causing financial hardship from an inability to work. Women also report feeling isolated, exhausted and helpless.

It’s important to stress that your baby will not be harmed by the retching and vomiting. However, there is a risk that if hyperemesis gravidarum is prolonged, your baby may have a low birth weight. There is also danger of dehydration in the mother.

When you should seek help

It is very important to seek medical help if you find yourself in a dehydrated state, unable to keep food or fluids down. Watch for:

  • Very dark yellow urine
  • Feeling light-headed or faint
  • Bloodied vomit
  • Vision changes
  • Shortness of breath
  • Extreme fatigue
  • Extreme weakness
  • Salivation
  • Losing more than five per cent of your body weight.

Call your doctor immediately for advice or seek hospital treatment.

Treatments

It may seem like a long, endless road, but there is help. Your doctor will conduct a full examination and investigate whether you need blood tests, liver and urine analysis, blood pressure and heart rate checks, IV fluids, and perhaps a pelvic ultrasound.

There are several medications that your healthcare professional may prescribe including an antiemetic (anti-vomiting) drug, particular types of antacids, potassium, vitamin B6, vitamin B1, steroids or antihistamines.

There is also anecdotal evidence that acupressure, acupuncture, ginger, evening primrose oil, and hypnosis can reduce symptoms. Expectant mothers should be careful about self-diagnosis and buying pharmaceutical products off the shelf. It is important to seek medical advice beforehand.

You may become unwell again after receiving treatment. If you are unable to keep food or fluids down for 24 hours, if you have very dark urine or you’re losing weight, seek immediate help again.

Some women find dietary changes can help, particularly if the nausea and vomiting is less extreme. Although it can be difficult, try to eat small meals, drink flat or fizzy mineral water often, and try to eat 10 to 15 minutes before getting out of bed. Dry crackers are ideal. Also, carry snacks in case hunger strikes because you will need to take advantage of every small window of opportunity. Avoid stress and whatever you find are your personal triggers. These could be flickering lights, loud noises, certain smells or car rides.

Causes

It is thought the hormone HCG may be responsible, but there are some risk factors:

  • If you’ve suffered from it during a previous pregnancy
  • A family history of hyperemesis gravidarum
  • If yours is a multiple pregnancy

If you are concerned about your morning sickness, contact your obstetrician, midwife or GP. Also seek support from other women suffering the condition and who understand what you are going through. As unpleasant and upsetting as it is, your symptoms will subside and you’ll have your newborn baby in your arms.

About the Author

Dr Philip Rowlands is a Consultant Obstetrician and Gynaecological Surgeon who has delivered more than 10,000 babies in Australia and the UK. To book in with Dr Rowlands, visit his website at www.drphiliprowlands.com.au or call his rooms on (08) 9448 6064. Glengarry Private Hospital is a 110-bed private hospital in Duncraig, Perth.