What is hyperemesis gravidarum?

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"Excessive weight gain during pregnancy increases the risk of your baby being born smaller than expected."
"Excessive weight gain during pregnancy increases the risk of your baby being born smaller than expected."

Karen Wilmot aka 'The Virtual Midwife' is a midwife, prenatal yoga teacher and founder of The Due Date Club, a private online community for pregnant women. 


Hyperemesis gravidarum is a fancy medical term for severe nausea and vomiting during pregnancy. The name comes from the word "emesis", which refers to vomiting.

Hyper indicates that the vomiting is excessive, and the word gravidarum refers to being pregnant. While the exact cause of severe and debilitating nausea and vomiting is unknown, it's believed to be caused by a rapidly rising blood level of the pregnancy hormone human chorionic gonadotropin (HCG).

It's usually associated with high pregnancy hormones, indicating a solid pregnancy. Hyperemesis gravidarum is more than morning sickness.

While nearly 85% of women will experience nausea during the first trimester, only 0.5 - 2% of those will be classified as hyperemesis gravidarum.

Read: Pregnant? This is what you need to know about placenta previa

So what is the difference, and how will you know if your inability to stomach your morning coffee is morning sickness or an indication to seek medical attention?

While nausea is an expected pregnancy symptom, it's usually manageable and is often resolved with natural remedies like peppermint tea, ginger and salty crackers.

Even if these remedies don't entirely stop the symptoms, they make it easier to cope and function regularly. Morning sickness usually stops by week 12, and life resumes as before.

With hyperemesis gravidarum, none of these remedies works, and the nausea can be so severe that it impacts your ability to go about your day.

Unlike morning sickness, nausea and vomiting continue beyond the first trimester and, left untreated, can lead to dehydration and nutritional deficiencies.

The vomiting can be treated with medication, but nausea can persist, making it difficult to eat, drink or function. Many women say the constant feeling of sickness is the hardest symptom to cope with.

Some women require hospitalisation for intravenous fluid rehydration and sometimes even nutrition via a feeding tube.

Food aversions and being sensitive to smell are often early signs of pregnancy and are common in the first trimester. With morning sickness, there is usually a handful of foods that you can stomach. With hyperemesis gravidarum, even water can induce vomiting.

The weird thing about hyperemesis gravidarum is that the more dehydrated you become, the more nauseated you become, and the more likely you'll vomit.

The most crucial treatment is IV hydration and medications to stop nausea and vomiting. The symptoms and severity vary from woman to woman but generally include excessive and rapid weight loss >_5% of body weight.

Without treatment, it's possible to lose more than 10% of body weight, which may impact your baby's growth.

Must read: What you need to know about the pregnancy complication called polyhydramnios

Remember. It's expected that you gain between 12 - 15kg during pregnancy, so weight loss needs to be investigated and treated accordingly.

The biggest concern when you have severe nausea and vomiting during pregnancy is how it may affect your baby. With so many changes happening during pregnancy, it's vital to ensure that your body is supported with adequate nutrition and hydration, and that's virtually impossible if you are unable to eat and constantly vomiting.

Medications such as Diclegis and Zofran provide relief and should be considered after assessing the potential risks and benefits thoroughly.

While most pregnant women prefer to avoid medication, it may be necessary so that they can eat and drink enough to avoid becoming dehydrated and malnourished. Excessive weight gain during pregnancy increases the risk of your baby being born smaller than expected.

Women with HG often need at least the occasional IV hydration treatment, while others require hospitalisation or continual homecare for regular IV hydration.

Hyperemesis gravidarum tends to peak during weeks 9 and 11, so the second trimester might feel slightly better than the peak period, but symptoms may still impact you daily.

Hyperemesis gravidarum can be frightening and will impact the ability to enjoy your pregnancy fully.

You may require frequent antenatal checkups to monitor your health and your baby's growth and hospitalisation to maintain your hydration and nutrition if you don't respond to medication.

Talk to your care provider about your options and ensure you are well informed to make an informed decision about your care.

Every test and investigation that is done in pregnancy gives information that tells your treatment plan. If you're at all concerned, it's always best to give your doctor a call.

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