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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One Response to “When morning sickness turns serious”

  1. SM Jolliffe says:

    Had this with both my pregnancies, 1st time I was told it is normal morning sickness by my GP (not being able to drink water or eat anything without throwing up the whole day for weeks and not even having energy to walk to the bathroom??), 2nd time I phoned my OB out of desperation and got hospitalized for 3 days to treat the dehydration and get meds that work. It is not only the physiological side that is difficult to handle, but psychologically this can cause severe depression, both for you and your family. If you have this, please join a support group (I joined one on Facebook). Nobody understands it and what you go through as much as people suffering from it with you.

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