Hyperemesis Gravidarum

Hyperemesis gravidarum is characterized by frequent vomiting that leads to a significant limitation in the ability to eat and drink and the complications that result from it. It is very common, during the first half of pregnancy, to experience nausea accompanied, sometimes, by vomiting. Nausea, with or without vomiting, occurs in many pregnant women. This phenomenon usually begins between the fourth and seventh week of pregnancy and lasts until the 16th week. Some women may experience this phenomenon for a longer period of time.

Women with hyperemesis gravidarum vomit so much that they lose weight and become dehydrated. These women may not eat enough food to fuel their bodies. The body then breaks down fat, causing ketones to build up in a condition called ketoacidosis.
Although this is called morning sickness, it is common throughout the day. In multifetal pregnancies and conditions such as gestational trophoblastic disease, nausea and vomiting are more common. A more extreme but less common condition is characterized by frequent vomiting, weight loss, dehydration and imbalance of salts or acid-base balance in the blood.

Causes of hyperemesis gravidarum


These symptoms can occur because, during pregnancy, levels of two hormones increase: human chorionic gonadotropin, which is produced by the placenta early in pregnancy, and estrogen, which helps maintain the pregnancy. Estrogen levels are particularly high in women with hyperemesis gravidarum. In addition, hormones such as progesterone, which are produced continuously during pregnancy, can slow the movement of stomach contents and contribute to nausea and vomiting.

Psychological factors may also play a role, hormonal causes, causes related to altered digestive system activity or increased presence of Helicobacter pylori associated with peptic ulcer formation. Hormonal changes that are very common during pregnancy have been suggested as one of the possible causes of nausea and vomiting in pregnancy. There is a relationship between vomiting and elevated thyroid hormone levels, as well as a relationship with human chorionic gonadotropin (hCG) levels.


Symptoms associated with hyperemesis gravidarum

Severe and prolonged nausea and vomiting
More salivation than usual
Dehydration, with symptoms including feeling thirsty, tired and dizzy, lack of urination, dark urine with a strong odor, dryness of the body and skin, and possibly loss of consciousness and fainting
Weight loss greater than pre-pregnancy weight.
Constipation, headaches, loss of appetite, inability to consume food and fluids
Postural hypotension and rapid heart rate


Complications of hyperemesis gravidarum

In hyperemesis gravidarum, possible complications include weight loss, dehydration, acid-base imbalance, such as metabolic acidosis due to malnutrition, or alkalosis due to frequent vomiting. There is also a salt imbalance and muscle weakness, as well as a general feeling of exhaustion. Hyperemesis gravidarum is the most common reason for a woman to be hospitalized in early pregnancy. Vomiting during pregnancy can go from being an acceptable and widespread phenomenon to a suffering that disrupts the normal activity of the pregnant woman, negatively affecting her mood, requiring frequent visits to the emergency room and even continuous hospitalization. Beyond the effects of vomiting, there are rare and serious complications of this situation, including esophageal damage, kidney damage and Wernicke’s encephalopathy.


Treatment of hyperemesis gravidarum

Lifestyle modification by dividing meals into small, multiple meals throughout the day, and drinking less and more frequently. If hot foods cause nausea, it is recommended to eat cold foods, and it is recommended to eat dry foods such as cookies. It is recommended to get enough sleep and avoid stress. And a diet rich in carbohydrates, and it turns out that ginger is useful in treating pregnancy-related nausea.

Take certain vitamins, supplements and herbs, as they can help relieve the symptoms of hyperemesis gravidarum and nausea. Treatment is divided, as each cause or complication of this condition has a separate treatment. Severe dehydration is supported by nutritional support and increased fluids in the body, the most important being drinking water.

Sometimes the drug causes serious complications for the pregnant woman and the fetus, but the standard treatment in most countries of the world is pyridoxine (Bendectin), which does not cause fetal malformations. This can help reduce the complications of the disease. In addition, since depression can be a secondary condition of hyperemesis gravidarum, pregnant women need emotional support, and sometimes counseling.



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