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Hyperemesis gravidarum: This helps against nausea

by Josephine Andrews
Published: Last Updated on 314 views

Pregnant women with hyperemesis gravidarum vomit more than 10 times a day. This is not only very psychologically stressful and exhausting, but also increases the risk of developing a lack of fluids, electrolytes, vitamins and other vital substances. Read here what effects hyperemesis gravidarum can have on mother and child and how doctors treat the disease.

Emesis or hyperemesis gravidarum?

Between 50 and 80 percent of all pregnant women are tormented by nausea (nausea) and vomiting (emesis gravidarum) – predominantly in the first twelve weeks of pregnancy. Some women have to endure the condition even beyond the 20th week of pregnancy (GW). But even if the unpleasant side effects are perceived as annoying and severely impair the quality of life, they are not a sign of a disease.

The situation is different with hyperemesis gravidarum, which occurs in 0.3 to 3 percent of all pregnant women. Here the nausea is accompanied by severe vomiting several times a day. More precisely: According to the definition, doctors speak of hyperemesis gravidarum when vomiting occurs more than ten times a day, during which the women cannot keep food or drink down, and lose more than five percent of their body weight.

Hyperemesis gravidarum begins predominantly between 6 and 8 weeks’ gestation , reaches its peak around 12 weeks’ gestation and decreases around 20 weeks ‘ gestation . It is one of the most common reasons for hospitalization in the first half of pregnancy.

Hyperemesis gravidarum: consequences for the mother

With severe hyperemesis gravidarum, the mother-to-be can eat and drink practically nothing without vomiting, and nausea is a constant companion. This means a strong psychological strain and a dwindling physical strength.

Further consequences for the mother can be:

  • Weight loss of more than five percent
  • Dehydration (dehydration)
  • electrolyte imbalances
  • Lack of vitamins, fats, minerals, sugars, etc.
  • increase in blood acids (ketosis)

As a result of these deficiencies, anemia, thrombosis, nerve and brain diseases (Wernicke encephalopathy) can occur. Damage to the esophagus due to frequent vomiting is also possible. A connection between hyperemesis gravidarum on the one hand and sleep disorders, anxiety and depression on the other hand could also be proven.

Hyperemesis gravidarum: consequences for the child

 Hyperemesis gravidarum can also have serious effects on the unborn child:

However, hyperemesis gravidarum does not seem to trigger spontaneous abortion ( birth before the 20th week of pregnancy) or infant death in the womb.

Risk factors for hyperemesis gravidarum

The causes of hyperemesis gravidarum are not yet fully understood. Contrary to the one-sided and outdated opinion that it is a purely mental illness, it is now assumed to be a multifactorial illness. This means that several risk factors together lead to the occurrence of severe morning sickness. Genetic reasons as well as hormonal (e.g. increase in human choringonadotropin or plasma protein A, PAPP-A), psychological (anxiety), sociocultural and ethnic factors are discussed.

The bacterium Helicobacter pylori ( H. pylori ) could also play a role. The stomach germ occurs in some pregnant women with hyperemesis gravidarum much more often than in expectant mothers without severe morning sickness. However, it is not known whether the bacterium is the cause or the consequence of hyperemesis gravidarum. 

Other risk factors can be young age, first pregnancy or multiple pregnancies. The body mass index, smoking or the economic background of the expectant mother do not seem to have any significance.

Diagnosis via exclusion method

Severe nausea, severe vomiting or a weight loss of more than five percent during pregnancy does not necessarily mean hyperemesis gravidarum. Doctors first try to clarify whether another disease might be causing the symptoms. These include, for example, gastrointestinal diseases (such as infections, gastritis, pancreatitis), neurological causes (such as migraines), urogenital diseases (such as urinary tract infections), metabolic diseases (such as increased calcium levels in the blood) or psychological disorders (such as eating disorders). The so-called mole pregnancy (cystic mole) – a rare malformation of the placenta – can also trigger hyperemesis gravidarum.

If all other possible diseases for the severe vomiting could be ruled out, the doctor will make the diagnosis of hyperemesis gravidarum.

Treatment of hyperemesis gravidarum

In hyperemesis gravidarum, lifestyle changes, complementary therapies, and medications can help relieve symptoms.

change of lifestyle

Occasionally it helps the affected pregnant woman to change certain habits in life. For example, small but frequent meals, eating biscuits before getting up in the morning, and getting plenty of rest can sometimes alleviate the severe morning sickness and constant nausea. Greasy or spicy foods and smells or situations that cause nausea should be avoided.

Complementary Methods

A number of complementary procedures appear to work in hyperemesis gravidarum. Acupressure, acupuncture, electrical stimulation and autogenic training, massages and homeopathic remedies ( Nux vomica , Pulsatilla ) may alleviate the symptoms. The medicinal plants ginger , chamomile and peppermint sometimes help against nausea and vomiting.

Complementary methods have their limitations. If the symptoms persist over a longer period of time, do not get better or even get worse, you should always consult a doctor!

medication

In the case of severe vomiting during pregnancy, however, lifestyle changes and complementary methods sometimes reach their limits. Vitamin B6 is then usually used as a medicinal measure . Other drugs that are given in hyperemesis gravidarum are antihistamines (such as doxylamine), dopamine antagonists, and H 3 antagonists. However, the data on these drugs in the treatment of the disease is relatively sparse. Further studies on this are needed.

When to the clinic?

If you suffer from hyperemesis gravidarum, are weak and have lost a significant amount of weight, do not hesitate to contact your doctor. Because before you or your child run the risk of being harmed, going to the clinic is clearly more sensible. There you can be helped with artificial nutrition (by infusion or tubes) to prevent possible consequences of hyperemesis gravidarum .

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