Hyperemesis Gravidarum
The majority of pregnant women experience some form of mild nausea and/or vomiting early in pregnancy. In fact, almost 50 percent of women experience some form of morning sickness. However, a very small percentage of women experience extremely severe and persistent nausea and/or vomiting. This is condition known as hyperemesis gravidarum (HG). This condition can make it difficult for a mother to consume the number of calories she needs, get enough fluids, and simply perform daily activities. If this condition is left untreated, it can lead to malnutrition, vitamin and mineral deficiencies, electrolyte imbalances, weight loss, dehydration, and even possible liver or kidney damage. These symptoms can all be damaging to the development of the fetus as well as to the health of the mother. When HG is treated properly, any adverse outcome to the baby-such as low birth weight, developmental problems, or prematurity-can be avoided.
Diagnosing
For some women, HG develops fairly rapidly within just a few weeks. For others, it may develop gradually over a period of a few months. Hyperemesis gravidarum is typically diagnosed through a thorough health exam, blood test, urine test, detailed health history, and the identification of symptoms characteristic to the condition including severe and persistent nausea and vomiting as well as dehydration and weight loss. HG is only considered as the final diagnosis when all other possible causes of severe and persistent nausea and vomiting have been ruled out. The condition typically begins in the period from week four to six and peaks between weeks nine and thirteen. Some women see significant improvements between weeks fourteen and twenty, while others may need significant care throughout the pregnancy.
Causes
The exact cause of hyperemesis gravidarum is not known. Though theories abound, none has yet been proven to be conclusive. Most likely, the condition is the result of more than just one factor. The factors may vary from woman to woman, depending on genetic makeup, body chemistry, and overall health. HG does seem to be more common in first-time pregnancies, women who are carrying more than one baby, younger women, obese women, and women who have had hyperemesis gravidarum in past pregnancies. Most theories focus on hormonal changes, such as an increase in estrogen and pregnancy hormone, physical changes, psychological causes, hyperthyroidism, gastric reflux problems, and nutrient deficiencies such as vitamin B6 and zinc.
Signs and Symptoms
There are many different symptoms of HG besides the obvious severe and persistent nausea and vomiting. Additional symptoms may include rapid heartbeat, anemia, dehydration, vitamin and mineral deficiencies, weight loss of 5 percent or more from pre-pregnancy weight, ketosis, excessive salivation, extreme fatigue, headache, strong food aversions and/or cravings, heightened sense of smell, gallbladder problems, and low blood pressure. There can also be complications from extensive vomiting, such as gastric ulcers and esophageal bleeding, that can worsen ongoing nausea. For many women, this condition has a financial impact as well as an emotional and social one. It can begin to greatly affect the quality of life. Sufferers may not be able to work, complete daily household chores, or even care for young children. The earlier proper medical treatment is given, the better chance for a decrease in severity of symptoms and for a quicker recovery with no complications.
Treatment
If you are diagnosed with hyperemesis gravidarum, you may need hospitalization to restore fluids, replace electrolytes, and to administer medications if needed. Some treatment plans may also include vitamin and mineral supplementation. Depending on the doctor, you may not be given food by mouth until the vomiting stops and dehydration has been rectified. Instead, your food will be supplied through a feeding tube, and you will begin on food slowly. Proper nutritional intake is one of the biggest challenges and most important issues for women who suffer from HG. If you are not getting sufficient nutrients to meet your baby's requirements, your baby will take it from your stores. This can deplete your nutritional reserves very quickly, and it might take months or even years for you to correct these deficiencies. Vitamins, especially the B vitamins, can be depleted very quickly, and if they are not replaced can worsen the symptoms. With hospitalization, you can get the proper care that is needed.