When morning sickness turns serious

Posted on 28 February 2018

The majority of women experience some degree of nausea and vomiting while pregnant – but approximately 3% (including the Duchess of Cambridge, Kate Middleton) develop a severe form called hyperemesis gravidarum. Here’s what you should know.

When the Duchess of Cambridge, Kate Middleton, fell pregnant with Prince George, she was hospitalised because her morning sickness was so extreme. Her following two pregnancies brought the same result. This isn’t unusual as women who have the condition during their first pregnancy have a higher chance of getting it again during subsequent pregnancies.

‘The symptoms of hyperemesis gravidarum usually appear between four to six weeks of pregnancy and usually get better at around 20 weeks, says Dr Josia Lebethe, an obstetrician/ gynaecologist at Mediclinic Medforum. ‘However, approximately one in five women may require care for this severe form of morning sickness throughout the rest of their pregnancy.’

These symptoms include: nausea and vomiting; excessive salivation; fatigue; weakness and dizziness. Sufferers may also experience sleep disturbance, irritability, decreased concentration and feeling faint.

‘Hyperemesis gravidarum can lead to weight loss, kidney malfunction, electrolyte imbalances and weakened muscles,’ Dr Lebethe adds. ‘Without treatment, there’s a higher chance your baby will be born prematurely or have a low birth weight.’

Dr Lebethe explains that although the exact cause is unknown, hyperemesis gravidarum appears to occur for a variety of reasons.

These include:

  • hormonal changes: Rising levels of human chorionic gonadotropin (hCG), oestrogen, and progesterone early in pregnancy
  • gastrointestinal dysfunction: Including regurgitation of the contents of the duodenum (upper small intestine) back into the stomach
  • increase in blood thyroxine levels
  • a multiple pregnancy (twins, triplets, etc.)
  • abnormal tissue growth in the uterus, called a hydatidiform mole
  • abnormal liver functioning
  • lipid alterations (abnormalities of fat in the blood)
  • inner ear problems
  • infection with Helicobacter pylori (H. pylori), an organism that causes stomach ulcers
  • deficiency of the nutrients pyridoxine and zinc

Although there is no cure for this condition, medication, such as anti-nausea drugs, might be necessary if your excessive vomiting might cause damage to you (maternal dehydration) or your unborn child. Your doctor is also likely to suggest you eat smaller meals more often. Drinking enough fluids with electrolyte replacement will also help.

‘If there is intolerance to oral intake it may be necessary for you to be admitted for rehydration via a drip,’ says Dr Lebethe. ‘This drip may contain Vitamin B in it, as well as anti-nausea medication.’

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