Hyperemesis Gravidarum Explained: What Causes Extreme Morning Sickness in Women?

Nausea and vomiting is a common occurrence in pregnancy experienced by at least 70% of women. It is typically referred to as morning sickness, although it can happen at any time of the day. However, there are instances when the symptoms are so severe that it can be diagnosed as a complication known as hyperemesis gravidarum.

What is Hyperemesis Gravidarum?

Hyperemeris gravidarum (HG) is an extreme form of morning sickness characterized by extreme, persistent nausea and vomiting experienced by a woman during pregnancy. This condition can happen in about 1 in 50 pregnant women.

Some women show signs of hyperemesis gravidarum as early as the fourth week of pregnancy and could be at its worst around weeks 9 to 13. The symptoms usually get better by week 20, although the condition can also persist until delivery.

Aside from severe nausea and vomiting, hyperemesis gravidarum can also cause increased salivation, low blood pressure, jaundice, and light-headedness. Another common symptom is increased sensitivity to smell, light, noise, and temperature changes.

Pregnant women who experience extreme morning sickness can become weak and exhausted. Since they cannot keep up their food or liquid intake, they may suffer from dehydration, electrolyte imbalances, and nutritional deficiencies. Additionally, constant vomiting can also reduce levels of important nutrients like thiamine, sodium, potassium, and magnesium.

According to the American College of Obstetricians and Gynecologists, hyperemesis gravidarum may be diagnosed when a woman loses 5% or more of her pre-pregnancy weight and experiences other health problems due to dehydration. HG can cause physical and mental discomfort and can interfere with a woman's work and personal life. As she feels so sick and wiped out, she may need to stop working and rest most of the day in bed. In the worst cases, the condition can be so distressful that about 10 - 15% of women with HG choose to terminate their pregnancies.

A woman with hyperemesis gravidarum during her first pregnancy is extremely likely to have it in subsequent pregnancies, with a recurrence rate of about 80%. There are also risk factors that can increase the likelihood of getting HG, such as multiple pregnancies, family history, and being pregnant with a girl.

Causes and Treatment for Hyperemesis Gravidarum

Experts are still uncertain about the real cause of hyperemesis gravidarum. However, there is a strong connection between this condition and rising hormone levels. During pregnancy, human chorionic gonadotropin (HCG) is produced very quickly and in large amounts. It peaks around week 10 of pregnancy, which also coincides with the season when most women report having the most severe symptoms.

Treatments for hyperemesis gravidarum depend on the symptoms and how this condition affects a woman's health. HG is the second leading cause of hospitalization in early pregnancy. Hence, the doctor may recommend one or more treatment options.

A severely dehydrated woman who cannot hold down any liquids may be given intravenous fluids to help replace electrolytes. Enteral feedings may also be administered through the stomach and intestines, or parenteral feedings through other routes like veins.

There are also antiemetic medications to help prevent vomiting in severe cases of hyperemesis gravidarum. Furthermore, a woman may be advised to avoid smells that can trigger nausea.

Lifestyle changes can also be recommended to help ease the symptoms. The woman might be advised to get smaller, more frequent meals and drinks, and to take electrolyte-replacement sports drinks and nutritional supplements.