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Notes on Women's Health
Notes on Women's Health

Is it Morning Sickness or Something More? What You Need to Know About Hyperemesis Gravidarum During Pregnancy

Feeling nauseous and even throwing up are common symptoms during pregnancy. In fact, The American Pregnancy Association states that more than 50% of women experience nausea during pregnancy. However, there are several differences between normal, expected morning sickness and a much more serious condition called hyperemesis gravidarum. Here is an in-depth examination of the signs and symptoms of hyperemesis gravidarum during pregnancy and what you should do if you suspect you’re suffering from this condition.

Morning Sickness

Morning sickness is a hallmark of the first trimester of pregnancy for many women. More properly called nausea and vomiting during pregnancy (NVP), since it can occur at any time (not only in the morning), this condition typically happens between the second and fourteenth weeks of pregnancy. The American Pregnancy Association reports that up to 85% of pregnant women experience at least one episode of nausea, and around 65% say they vomited at least once.

For most women, nausea and vomiting are self-limiting after their first trimester. If you experience morning sickness, avoiding foods or odors that trigger your nausea may help. Your OB-GYN may also be able to offer advice and medication to help you deal with the issue.

Hyperemesis Gravidarum During Pregnancy

While morning sickness is well-known, you may have never heard of HG. Hyperemesis is not a normal part of pregnancy but rather a complication. Only around 3% of women encounter HG during their pregnancies. However, for these women, HG is a serious condition that requires professional medical monitoring and care. HG usually begins in the first trimester, and usually ends by 16 weeks. However, symptoms continue until the third trimester in 15 – 20 % of patients with HG, and until delivery by 5%. Symptoms may wax and wane in severity during the entire pregnancy, or they may persist at a constant level.

HG is more than just a bad case of morning sickness. Pregnant women suffering from HG usually vomit three to four times per day. This vomiting is far more frequent than that of typical morning sickness. In some instances, women with HG may throw up so frequently that they experience weight loss, dehydration, and dizziness which can lead to falls.

Risk Factors for Developing HG

Doctors have identified multiple risk factors for developing HG. While you cannot eliminate most of these factors, getting to a healthy weight before conception may lower your risk for HG. The risk factors include:

  • Obesity or being overweight
  • First-time pregnancy
  • Having multiple pregnancies (twins, triplets, etc.)
  • Having HG during a previous pregnancy
  • Family history of HG

Researchers have long thought that HG was due to changes in hormone levels during pregnancy. However, recent research has identified variations in two specific genes leading to HG. This discovery means that the propensity for HG is genetic.

How Dangerous is HG?

If severe or left untreated, HG may endanger the life of the mother and the life or development of the fetus. The danger arises from severe dehydration and electrolyte imbalances from vomiting. These conditions may require IV fluids or hospitalization for treatment.

In addition, HG can contribute to mental health problems. HG can place a severe, stressful burden on a woman. While no one likes to feel nauseous, HG is much more than just an annoyance. Women suffering from HG may feel as if they’ve lost control of their bodies. The frequent vomiting and inability to eat what they like can lead to significant depression. Women with severe cases of HG may even be at risk for self-harm.

What to Do

Always keep your OB-GYN apprised of your condition and any symptoms throughout your pregnancy, including episodes of nausea and vomiting. As part of your prenatal care, your OB-GYN will conduct routine blood tests that will reveal electrolyte imbalances, but you are always the best source of health information. Tell your doctor how you feel and let them know if you have any concerns about the course of your pregnancy.

If you do encounter nausea and vomiting, consult with your OB-GYN before taking any medications or making major modifications to your diet. The source of your nausea may not be related to your pregnancy. Your OB-GYN will work with you and your other physicians to identify the cause of your problem and recommend appropriate treatments.

About the Connecticut OBGYN Practice

Dr. John Garofalo, M.D., is a CT OBGYN based in Fairfield County, providing care for Norwalk, Darien, New Canaan, Weston, Rowayton and the surrounding areas. He has more than 20 years of practice and surgical experience covering many facets of obstetrics and gynecology.

Laury Berkwitt, APRN, is a nurse practitioner specializing in women’s health in Fairfield County, Connecticut. Women undergoing signs and symptoms of menopause can make an appointment with Laury for Hormone Replacement Therapy. Laury has a passion for providing quality women’s health care in a safe and comfortable manner by creating a trusting patient-practitioner relationship. She has been in practice for more than 10 years, caring for women of all ages.