20 Aug Hyperemesis Gravidarum (Excessive vomiting in pregnancy)

What is Hyperemesis Gravidarum?
Hyperemesis Gravidarum is a condition in which a woman suffers from excessive vomiting during pregnancy. They usually throw up so often that they can’t even digest the amount of food and fluid required to stay healthy that further results in dehydration and electrolyte imbalances and drastic loss in weight. The woman who suffers from this problem might even have complications for them and their babies. It is advisable to begin the treatment as soon as the problem is diagnosed.

Causes of Hyperemesis Gravidarum
The cause of Hyperemesis Gravidarum is not entirely clear. Hormonal changes in pregnancy, changes in gut motility and functioning as well as psychological factors have been implicated in manifestation of excessive vomiting in pregnancy. It is very common to have nausea and vomiting during the first 3 months of pregnancy. Few reasons that can cause Hyperemesis Gravidarum are listed below:
1. Rapid increase in the blood level of a hormone that is released by placenta called as human chorionic gonadotropin (HCG) can cause this problem.
2. Hyperemesis Gravidarum can occur if woman is carrying twins or more babies.
3.Molar pregnancy

Symptoms of Hyperemesis Gravidarum

Below are the symptoms:
1. Persistent nausea
2. Loss of weight
3. Constipation
4. Dehydration
5. Weakness and Headache
6. Unusual salivating
7. Low blood pressure
8. High pulse rate

Tests
You may have to undergo few tests to check for Hyperemesis Gravidarum:

1. Complete blood count
2. Urine Ketones
3. Serum Electrolytes
4. Tests for functioning of liver
5. Ultrasound to check if you are carrying twins .
6. Ultrasound to check for hydatidiform mole.
7. Thyroid Function Tests(TSH , FT4)
8. Urine Culture

Differential Diagnosis
Other causes of excessive Vomiting in pregnancy should also be considered. These could be
1. Urinary Tract Infections(UTI)
2. Gastroenteritis
3. Thyroid Dysfunction ( Hyperthyroidism), Diabetic Ketoacidosis
4. Peptic ulcer disease , Gall Bladder stones /Cholecystitis , Liver Infections (hepatitis) etc.

Complications

Untreated Hyperemesis Gravidarum can have serious consequences for the pregnant woman and her baby in the form of
• Severe dehydration
• Electrolyte imbalances. Severe Hyponatremia ( low Blood Sodium levels) can cause Seizures , Coma and Respiratory arrest.
• Vitamin Deficiences ( Vit B1 , Vit B12 , Vit B6) – can cause neuropathies , Encephalopathy
• Malnutrition
• Psychological Upset in the woman

Treatment
1. If a pregnant woman is suffering from vomiting and has become dehydrated then admission in a hospital is advised and fluids are given through IV drip.
2. Anti-nausea medicines and vitamin supplements are also given to treat the problem.
3. Avoid doing things that triggers nausea in your case. It can be because of certain smells, taking showers, bright light, travelling in a car or loud noise.
It is very important to keep yourself healthy in order to have a healthy baby. Eat well and drink lots and lots of fluid whenever you feel you can digest the same. Eat what appeals you. Take vitamin B6 every day. It helps in reducing nausea in first trimester. With proper identification of causes and being careful at every step can help to reduce this problem. Call your gynaecologist if you have problem of nausea or you can schedule an appointment with our Gynaecologist Dr. Manavita Mahajan