Hyperemesis gravidarum

Hyperemesis Gravidarum strikes pregnant women. It is an unusually severe form of morning sickness. Morning sickness is a normal part of pregnancy. Although it's unpleasant, it doesn't harm the mother or the baby. Hyperemesis gravidarum, however, causes severe vomiting. It can cause liver or kidney damage in the mother. It can also prevent the baby from growing normally.

The causes are unknown.

A risk factor is something that increases your chance of getting a disease or condition.

• Hyperemesis gravidarum during a previous pregnancy
• Being overweight
• Multiple pregnancy (more than one fetus)
• First time mothers
• Trophoblastic disease

Hyperemesis Gravidarum usually occurs during the first trimester of pregnancy. You may have Hyperemesis Gravidarum if you are pregnant and you vomit:

• More than 3-4 times per day
• So much that you lose more than ten pounds
• So much that you are becoming dehydrated
• Enough to develop unbalanced blood chemicals (a condition called ketosis)

The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include:

• Blood tests to check the balance of chemicals in your blood
• Urine tests to monitor your level of dehydration
• Thyroid tests (because thyroid disease can mimic hyperemesis gravidarum)
• Ultrasound tests to check on the health of the baby

The kind of treatment you require depends on how ill you become. Possible treatments include:
Intravenous Fluids
Intravenous (IV) fluids may be given for a brief period of time, until you are no longer dehydrated. They may be discontinued when you're able to take in fluids by mouth. If you continue to vomit throughout your pregnancy, you may need IV fluids until you deliver your baby. Other nutrients can be added to the IV fluids to help keep the blood chemicals in balance.
Total Parenteral Nutrition
The most severe cases of Hyperemesis Gravidarum may require that complex, balanced solutions of nutrients be given through an IV throughout pregnancy. This is called total parenteral nutrition (TPN).
Medications
Certain anti-nausea medicines may be used during pregnancy. If you can't take anything by mouth, medicines may be given through your IV or via a suppository.
Medicines used include:

• Promethazine
• Meclizine
• Ondansetron
• Droperidol
• Metoclopramide

Steroid Burst
A short course of steroids is sometimes helpful in treating Hyperemesis Gravidarum.
Small, Bland Meals
If the above treatments help you stop vomiting, you may be allowed to begin eating again. You'll be asked to eat small meals often during the day. Most women feel better eating bland foods.

Although there are no known ways to prevent Hyperemesis Gravidarum the following measures may help keep morning sickness from becoming severe:

• Eat small, frequent meals
• Eat bland foods
• Keep crackers by your bed, and eat a few before getting up
• Wait to take iron supplements until your nausea has improved
• Discuss complementary therapy with your doctor, including:
  • Ginger
  • Acupressure