While previously known as a common cause of death in pregnancy, with proper treatment this is now very rare. Those affected have a lower risk of miscarriage but a higher risk of premature birth. Some pregnant women choose to have an abortion due to HG symptoms. Signs and symptoms
When vomiting is severe, it may result in the following:
Loss of 5% or more of pre-pregnancy body weight
Dehydration, causing ketosis, and constipation
Nutritional disorders, such as vitamin B1 (thiamine) deficiency, vitamin B6 (pyridoxine) deficiency or vitamin B12 (cobalamin) deficiency
Metabolic imbalances such as metabolic ketoacidosis or thyrotoxicosis
Physical and emotional stress
Difficulty with activities of daily livingSymptoms can be aggravated by hunger, fatigue, prenatal vitamins (especially those containing iron), and diet. Many women with HG are extremely sensitive to odors in their environment; certain smells may exacerbate symptoms. Excessive salivation, also known as sialorrhea gravidarum, is another symptom experienced by some women. Hyperemesis gravidarum tends to occur in the first trimester of pregnancy and lasts significantly longer than morning sickness. While most women will experience near-complete relief of morning sickness symptoms near the beginning of their second trimester, some people with HG will experience severe symptoms until they give birth to their baby, and sometimes even after giving birth.A small percentage rarely vomit, but the nausea still causes most (if not all) of the same issues that hyperemesis with vomiting does. Causes
There are numerous theories regarding the cause of HG, but the cause remains controversial.
Patients might receive parenteral nutrition (intravenous feeding via a PICC line) or enteral nutrition (via a nasogastric tube or a nasojejunal tube). There is only limited evidence from trials to support the use of vitamin B6 to improve outcome. An oversupply of nutrition (hyperalimentation) may be necessary in certain cases to help maintain volume requirements and allow weight gain. A physician might also prescribe Vitamin B1 (to prevent Wernickes encephalopathy) and folic acid. Alternative medicine
Acupuncture (both with P6 and traditional method) has been found to be ineffective. The use of ginger products may be helpful, but evidence of effectiveness is limited and inconsistent, though three recent studies support ginger over placebo. Complications
Pregnant woman
If HG is inadequately treated, anemia, hyponatremia, Wernickes encephalopathy, kidney failure, central pontine myelinolysis, coagulopathy, atrophy, Mallory-Weiss tears, hypoglycemia, jaundice, malnutrition, pneumomediastinum, rhabdomyolysis, deconditioning, deep vein thrombosis, pulmonary embolism, splenic avulsion, or vasospasms of cerebral arteries are possible consequences. Depression and post-traumatic stress disorder are common secondary complications of HG and emotional support can be beneficial. Infant
The effects of HG on the fetus are mainly due to electrolyte imbalances caused by HG in the mother. Infants of women with severe hyperemesis who gain less than 7 kilograms (15 lb) during pregnancy tend to be of lower birth weight, small for gestational age, and born before 37 weeks gestation. In contrast, infants of women with hyperemesis who have a pregnancy weight gain of more than 7 kilograms appear similar to infants from uncomplicated pregnancies.