What is Hyperemesis Gravidarum?
yperemesis gravidarum (HG) is severe nausea and vomiting during pregnancy. Women with this condition can’t keep enough food and fluid down to stay healthy. The result is dehydration, weight loss, and risks to their unborn babies. HG can be difficult to manage, but the sooner you’re diagnosed, the sooner you can begin treatment – usually a hospital stay and intravenous fluids.
“Women who are likely to develop HG are those expecting twins or triplets and 50 per cent of the cases could be due to hereditary factors or genetic predisposition,” says Dr Maria Nikolopoulou, Obstetrics/Gynaecology Specialist at AMC Clinic, Dubai Healthcare City. She treats one to two women suffering from HG per month.
The symptoms usually appear between four and six weeks of pregnancy and may peak around nine to 13 weeks. Dr Nikolopoulou says the exact cause of HG remains unknown, but it is believed to be a result of a combination of factors, including genetics, body chemistry, and overall health.
“One of the factors is an adverse reaction to the hormonal changes during pregnancy, for instance increased levels of beta human chorionic gonadotropin (hCG). This would explain why most women experience HG in the first trimester as hCG levels are highest during this phase,” she explains.
“HG has also been linked to an increase in levels of oestrogens, which decreases intestinal motility and gastric emptying leading to nausea/vomiting.
“Also women who are prone to travel sickness, migraines or have a pre-existing liver disease are predisposed to develop the condition.”
Dry, bland food and oral rehydration are first-line treatments. Acupressure often works. “The pressure point to reduce nausea is located at the middle of the inner wrist, three finger lengths away from the crease of the wrist, and between the two tendons,” says Dr Nikolopoulou. “Locate and press firmly, one wrist at a time, for three minutes.”
In extreme cases patients are hospitalised and put on an intravenous drip to restore hydration, electrolytes, vitamins, and nutrients. There is no known prevention of HD.