What is hyperemesis?
Hyperemesis is the severe form of nausea and vomiting that lasts past the 14th week of pregnancy. Nausea and vomitting of pregnancy occurs in 70-85% of pregnant women in various degrees of severity. It begins before the 9th week and usually lasts only a few weeks. Hyperemesis gravidarum, on the other hand, is so severe that there is a disturbance in food intake, altered electrolytes, dehydration, and weight loss.
What causes hyperemesis?
The cause of hyperemesis is thought to be a hormonal imbalance that occurs with pregnancy. However, when a woman has severe nausea and vomitting, other medical conditions which can cause this must be considered and excluded.
What are the symptoms?
The primary symptom of hyperemesis is morning sickness that develops into persistent vomiting and lasts past the first 14 weeks of pregnancy. The pregnant woman vomits several times a day and is unable to hold down food or fluids. She loses weight and becomes dehydrated. Her skin and mucous membranes are dry, and her blood pressure may decrease.
What is the treatment?
The treatment for hyperemesis varies depending on your condition. Treatment may begin at home. This care will usually include the following:
- Take a prenatal vitamin every day
- Eat dry starchy foods such as dry toast, melba toast, crackers, rice cakes, dry cereal, bagels, English muffins and biscuits.
- Suck on crystalized ginger, drink ginger tea or ginger ale
- Buy acupressure bands (sea sickness bands available in local pharmacies) and use at the P6 point according to directions
- Avoid excessive amounts of fluid early in the day or when nauseated. Be sure to make up for the fluid at another time during the day. Do not drink fluids with meals. Try such foods and fluids as jell-o, sherbet, popsicles and juices that you can tolerate. Watermelon helps many women.
- Eat small amounts of food frequently and avoid large meals. Instead of eating three full meals, divide the amount you would eat into smaller meals. For example, eat a small breakfast, then a mid-morning snack.
- Eat a small lunch and a mid-afternoon snack. Eat a small dinner and a bedtime snack.
- Avoid skipping meals.
- Decrease the amount of fatty foods you eat. Instead of eating fried foods, eat foods that are baked.
- Use vegetable sprays instead of oils or grease when frying foods.
- Avoid cooking odors.
- Choose foods that can be served at a cool temperature and with little aroma.
- Avoid stressful situations and get plenty of rest. Try to relax and rest by taking walks, sitting with your feet elevated, or lying down and using relaxation exercises such as deep breathing. Take a deep breath in through your nose and breathe out through your mouth like you are blowing up a balloon four to six times. This will help you to relax.
- Try progressive muscle relaxation. Sit relaxed in a chair or lie down and systematically tense and relax each of your muscle groups. For example, tense all the muscles in your right arm and then relax them; next, tense and relax your left arm and so on until you have relaxed all the muscles in your body.
- Use good oral hygiene. You should brush your teeth and rinse your mouth out frequently throughout the day. Mouthwashes or salt water are good to use. Avoid over-the-counter medicine or home remedies to help the nausea. Your doctor may prescribe certain medication and you should take it as ordered.
- There are also medications which your physician may prescribe for you depending on the severity of your symptoms and your response to the above self-help measures
- Discuss the occurence of nausea and vomitting with your physician because studies have shown that early treatment of these symptoms can often prevent the progression to hyperemesis
What will happen if hospitalization is necessary?
If hospitalization is necessary, you will not be given food or fluid until your nausea has stopped. Your doctor will order intravenous fluids and a quiet environment so that you may rest. Once vomiting has stopped, you will begin to take solid food by mouth, and your diet will be gradually increased. Oral fluids will be added slowly and cautiously. Your hydration will be maintained with intravenous fluids until you are able to keep both food and fluids down. There are also medications which your physician may prescribe for you depending on the severity of your symptoms.
Last Updated: September 24, 2009