CEN Hyperemesis Gravidarum

CEN Hyperemesis Gravidarum Overview

Morning sickness is nausea and vomiting that occurs during pregnancy. And, despite its name, morning sickness can strike at any time of the day or night.

Many pregnant women have morning sickness, especially during the first trimester. But some women have morning sickness throughout pregnancy. Management options include various home remedies, such as snacking throughout the day and sipping ginger ale or taking over-the-counter medications to help relieve nausea.

Rarely, morning sickness is so severe that it progresses to a condition called hyperemesis gravidarum. This is when someone with nausea and vomiting of pregnancy has severe symptoms that may cause severe dehydration or result in the loss of more than 5 percent of pre-pregnancy body weight. Hyperemesis gravidarum may require hospitalization and treatment with intravenous (IV) fluids, medications and rarely a feeding tube.

Signs and Symptoms

Common signs and symptoms of morning sickness include nausea and vomiting, often triggered by certain odors, spicy foods, heat, excess salivation or – often times – no triggers at all. Morning sickness is most common during the first trimester and usually begins by nine weeks after conception. Symptoms improve for most expectant mothers by the mid to late second trimester.

Causes

What causes morning sickness isn’t clear, but the hormonal changes of pregnancy are thought to play a role. Rarely, severe or persistent nausea or vomiting may be caused by a medical condition unrelated to pregnancy — such as thyroid or liver disease.

Risk Factors

Morning sickness can affect anyone who’s pregnant, but it might be more likely if:

• You had nausea or vomiting from motion sickness, migraines, certain smells or tastes, or exposure to estrogen (in birth control pills, for example) before pregnancy
• You had morning sickness during a previous pregnancy
• You’re pregnant with twins or other multiples

Complications

Mild nausea and vomiting of pregnancy typically won’t cause any complications to you or your baby.

If left untreated, severe nausea and vomiting can cause dehydration, an electrolyte imbalance, decreased urination and hospitalization. Research is mixed on whether hyperemesis gravidarum causes poor weight gain for your baby during your pregnancy.

Treatment

If your morning sickness symptoms persist, your health care provider may recommend vitamin B-6 supplements (pyridoxine), ginger and over- the-counter options such as doxylamine (Unisom) for management. If you still have symptoms, your health care provider may recommend prescription anti-nausea medications.

Moderate to severe nausea and vomiting of pregnancy may cause dehydration and electrolyte, such as sodium or potassium, imbalance. Extra fluids and prescription medications are recommended for moderate to severe morning sickness.