The truth about morning sickness - aka Hyperemesis Gravidarum
My story and experience with Hyperemesis Gravidarum (HG)
What is Hyperemesis Gravidarum?
HG is a debilitating, and potentially life-threatening pregnancy condition. It can cause dehydration, weight loss, malnutrition due to severe nausea and vomiting, and may cause long term health issues for mum and baby.
- Socioeconomic changes, for example, job loss resulting in financial difficulties
- Psychiatric sequelae, for example:
- Depression (including postpartum)
- Anxiety, fear of future pregnancies
- Guilt for choosing to terminate the pregnancy, approximately 1,000 women a year choose to terminate because of the extreme effects of HG
- Extremely heightened sense of smell
- Extreme fatigue
- Extreme isolation
What causes Hyperemesis Gravidarum?
What treatment is available for morning sickness?
In addition to changes to diet and lifestyle, medicinal methods can help with the prevention and treatment of HG. There are various treatment options which can include:
- Antiemetics are usually the most common and effective for vomiting, for example, Ondansetron (Zofran) and Metoclopramide. However, they should not be used in the first trimester due to potential damage to the developing foetus
- Acid reducing medications or proton pump inhibitors such as cimetidine and omeprazole help with heartburn and esophagitis
- IV hydrocortisone
- Oral methylprednisolone
- Parenteral nutrition can be administered centrally or peripherally to address chronic dehydration and malnutrition
- Oral thiamine (1.5mg/d) before the onset of nausea/vomiting is recommended
- Vitamins and minerals (particularly B1, folic acid, K, Mg, D) within 2 weeks of reduced nourishment and nausea/vomiting to avoid worsening of HG symptoms
- Scheduled IV to replace lost fluid and electrolytes. Antiemetics can also be injected via a vein or a muscle if the vomiting is severe
Where can I find support and more information?
Pregnancy Sickness Support is a UK charity that participates in ongoing research and aims to raise awareness to both the public and healthcare professionals about HG, they have a vast amount of information and advice on their website, an online support forum, and a helpline for those suffering from hyperemesis gravidarum and severe morning sickness.
- HER Foundation website. https://www.hyperemesis.org
- Jennings LK, Mahdy H. Hyperemesis Gravidarum. 2021 Aug 25. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–.
- Fejzo MS, Macgibbon KW, Romero R, et al. Recurrence risk of hyperemesis gravidarum. J Midwifery Womens Health. 2011 Mar-Apr;56(2):132-6
- Poursharif, B., Korst, L., Fejzo, M. et al. The psychosocial burden of hyperemesis gravidarum. J Perinatol 28, 176–181 (2008).
- Pregnancy Sickness Support website. https://www.pregnancysicknesssupport.org.uk/
- Fejzo, M. S., Brecht-Doscher, A., Kimber MacGibbon, R., et al. The impact of and risk factors for HG: treatment, genetics, and epidemiology. Available at: https://www.pregnancysicknesssupport.org.uk/documents/conference_papers/The_impact_of_and_risk_factors_for_HG.pdf
- Wegrzyniak LJ, Repke JT, Ural SH. Treatment of hyperemesis gravidarum. Rev Obstet Gynecol. 2012;5(2):78-84.
- Jueckstock JK, Kaestner R, Mylonas I. Managing hyperemesis gravidarum: a multimodal challenge. BMC Med. 2010;8:46.