Hyperemesis Gravidarum

Many women experience nausea and vomiting during their first trimester and sometimes into their second trimester due to hormonal changes brought on by the pregnancy. In some instances, the “morning sickness” will be so severe that weight loss and severe dehydration occurs which is then called hyperemesis.

How Can Hyperemesis Effect Me?

In a time when most women are counting the pounds that they have gained, women with hyperemesis will struggle to maintain their prepregnancy weight and usually loose as much as 5% of their prepregnancy weight during the first trimester. As a result of the weight loss, a condition called ketosis can develop which will prevent the proper absorption of nutrients and fats. This can also result in an electrolyte imbalance from the lack of salt absorption into the blood stream. Women with severe hyperemesis will feel extremely tired and begin to loose muscle mass.

How Do I Know If My Morning Sickness Is Hyperemesis?

Signs that you should alert your doctor to are the following:

• Inability to keep any fluids down in a 24 hour period.
• Weight loss of 5 or more pounds
• Infrequent urination
• Extreme tiredness and/or weakness

Your doctor may run tests to determine the level of ketones in your urine and to check for an electrolyte imbalance.

What Can Be Done For Hyperemesis?

The most important task to reverse the effects of hyperemesis is to keep fluids and nutrients down. Your doctor may do one or more of the following:

• Order an IV to replace fluids directly into your blood stream (rehydrate).
• Order medication like Phenergan (Promethazine), Bedectin, or Reglan to alleviate nausea and vomiting.
• Antibiotic therapy to eliminate bacteria in the stomach (similar to the treatment of an ulcer).
• Hospitalization may be required for treatment.

How Will It Effect The Growth And Development Of My Baby?

Hyperemesis is fairly rare and in only a few cases of those women who develop severe vomiting, does it endanger the life of the mother and the fetus. In cases where nutrient depletion is so great that it may threaten the fetus, a procedure called IV hyperalimentation may be performed. This procedure adds nutrients directly into the blood stream and allows the mother’s gastrointestinal tract to rest.

The most important way to protect the development of your baby is to always keep your doctor informed of your symptoms. Call your doctor immediately if you experience any of the symptoms listed above.

Dietary Guidelines:

1. Small frequent meals
2. Place crackers or toast next to your bedside and nibble before getting up
3. Don’t drink fluids with meals as your stomach fills quickly. Try sipping fluids between meals.
4. Low fat foods are easier to digest, (lowfat milk, lean meat, broiled or canned fish, poultry without skin.
5. Eat carbohydrates that are easy to digest (rice, pasta, potatoes, cereals, crackers, and ginger snaps)
6. Avoid highly seasoned foods.
7. Avoid foods that give you gas. (cabbage, broccoli, onions, sweet potatoes, buttermilk, pinto or pork beans)
8. Eat protein snacks before going to bed.
9. Peppermint tea, ginger tea, gatorade, 7-up, ginger ale
10. Guard against dehydration

General Recommendations:

1. Get plenty of fresh air.
2. Remove odors from surroundings.
3. Rise slowly from bed, give yourself a few minutes to adjust.
4. Wear non-restrictive clothing
5. Rest
6. Heating pad or hot water bottle to sooth sore abdominal muscles from vomiting.
7. Call if you are unable to keep down fluids > 24 hours.

Medications:

DO NOT take any antinausea medicines without consulting your healthcare provider. Certain antihistamines have been shown to cause birth defects in animals.

You may want to avoid taking your prenatal vitamin for a couple of days. Some women are very sensitive to the iron and the concentrated vitamins. Try also to take a 1/2 tablet at bedtime for a few days and then 1/2 tablet at lunch time.

• Vitamin B-6 50mg 1 in AM, 1 in PM
• Unisom 1/2 tablet a day
• Accupressure bands or copper wrist bands
• Papaya enzyme pills