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Not Just Morning Sickness: What Is Hyperemesis Gravidarum?

Yonah Leserowitz Yonah Leserowitz
December 30, 2020

So you think you know a lot about pregnancy? Almost everyone at some point in their lives knows someone who has been pregnant, whether it’s a spouse, family member, coworker, or even yourself! Because pregnant women are a common sight, people have a relative familiarity with what it’s like to be pregnant. After all, don’t we all suffer along with the pregnant woman when she complains to us about what’s going on? The aches and pains, the food aversions, the swelling, and worst of all … the nausea and vomiting. 


For most women, these symptoms can cause mild to moderate discomfort that’s simple enough to alleviate. Some fortunate women don’t experience symptoms at all. But there is another group of women for whom getting pregnant causes them dangerous symptoms. They can be hospitalized several times over the course of their pregnancy and for stretches at a time depending on just how severe their symptoms are. This, of course, throws everything out of whack for them. What can they (and can’t they) eat? Do they need to be under constant monitoring? Can they even function if they’re constantly running to the bathroom to throw up?

 

This condition is called hyperemesis gravidarum, or HG for short. One’s first thought to say to someone suffering from this condition might be “Oh, it’s not so bad! All women get nauseous and throw up when they’re pregnant!”  Stop right there–this can be very serious.

 

According to the National Organization for Rare Disorders, HG occurs in between .5% to 2% of all pregnant women. Symptoms usually start between the 4th and 6th week of pregnancy and can peak at weeks 14 to 20. Some women experience severe symptoms throughout the entire course of their pregnancy. What distinguishes HG from regular pregnancy symptoms? For starters, with HG,  nausea is not just feeling a little sick–it always comes with severe vomiting. With HG, feelings of nausea continue throughout the entire pregnancy. During a normal pregnancy, there is not the severity of nausea and vomiting; therefore, the risk of dehydration is not present. However, with HG, because of the severity of the vomiting, it can cause severe dehydration to the point of requiring hospitalization and the inability to keep any food down. Other symptoms that come along with HG? A decrease in urination (due to dehydration), headaches, confusion, fainting, jaundice, low blood pressure, a rapid heart rate, extreme fatigue, skin that becomes less elastic, and secondary anxiety and or depression. And finally, because of the inability to keep food down, many women lose 5% of their body weight. This is usually the symptom that causes them to go to their doctor and get diagnosed. And it’s rather alarming, considering that most women must gain weight during pregnancy to maintain a healthy fetus–and their own health.

 

So what causes HG?

According to the US National Library of Medicine, no one is actually sure. The one clue that doctors have is that it may be caused by a high level of the hormone human chorionic gonadotropin (or HCG), which is released by the placenta. The National Organization for Rare Diseases disputes that, however. They claim that HCG is an outdated theory, and that new evidence better supports the hormone GDF15, a placenta and appetite hormone, for being the culprit. They also posit that there is genetic evidence for other hormones such as GFRAL, PGR, and IFGBP7 for being additional culprits. 

 

So you or someone you know has HG? Now what?

Believe it or not, treatment options do exist for women suffering from HG. What works and how effective it is depends on the severity of the symptoms. For starters, something as simple as lifestyle changes may work. That includes avoiding triggers if you’re aware of any that specifically induce nausea. Eating and drinking bland foods in smaller amounts throughout the day may also help in order to tolerate meals better. Your doctor may suggest vitamin B6 as a supplement, as it has been shown to potentially reduce nausea, or herbs such as peppermint and ginger which are well-known natural remedies. However at the end of the day, if you can’t keep any food or liquids down, have lost (rather than gained) weight, and/or are becoming dehydrated, you may be required to go to the hospital. Treatment at the hospital may include an IV to get some liquids in, tube feeding to get nutrients in, and various medications to help with the symptoms. 

 

Hyperemesis Gravidarum is not just your run-of-the-mill pregnancy nausea. It is a serious disease with negative impact on the health of the mother and the fetus and should be treated in a serious manner. If you or someone you know is struggling with more than just morning sickness symptoms, talk to your doctor right away. 

 

References

*https://rarediseases.org/rare-diseases/hyperemesis-gravidarum/

*https://americanpregnancy.org/pregnancy-complications/hyperemesis-gravidarum/

*https://medlineplus.gov/ency/article/001499.htm

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