Extreme pregnancy sickness hyperemesis gravidarum: What you need to know

What is hyperemesis gravidarum?

A complication of pregnancy in which women experience extreme levels of nausea and vomiting.

Another name for ‘morning sickness’ then?

Absolutely not. Note the words “extreme levels” above to describe what is a medical condition which can very quickly cause severe dehydration and malnutrition. If not adequately treated, it is potentially life-threatening. “Morning sickness” is part of a normal pregnancy, and hyperemesis is not.

[ ‘I was like, I don’t know how sick you have to be, but I am pretty sure I’m there’ ]

Does it happen often?

Between 1 and 3 per cent of pregnant women are affected. The onset is likely to be early in the first trimester, often within days of or even before getting a positive pregnancy test. Symptoms may ease by about 15 weeks, but NMH research midwife Jean Doherty says that, in her experience, once the condition persists beyond that point, women are likely to have to endure it throughout their pregnancy.

What are the symptoms?

If a woman can’t keep down enough water to stay hydrated or enough food to maintain her weight, she should seek medical care. If the nausea and vomiting are so frequent she is unable to function, she may well have, or be developing, the condition.

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How is it diagnosed?

In addition to questions about a pregnant woman’s patterns of nausea and vomiting, which are measured with a clinically recognised Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) scoring system, testing of urine and blood will give further indications of the extent of dehydration and other signs such as electrolyte imbalances and ketosis, when the body is forced to burn fat for energy instead of glucose

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How is it treated?

The intravenous administration of fluids and nutrition should address immediate dehydration and malnutrition concerns. But this may have to be repeated regularly, with some patients requiring overnight hospital admission. Anti-sickness medication may be effective in longer-term management of the condition. However, what drug, or combination of drugs, works best for each individual, and even each pregnancy of that individual, may only be identified through trial and error. Psychological support should also be offered to anybody experiencing this distressing condition, the fallout from which can affect women long after giving birth.

Can it harm the baby?

If hyperemesis is left untreated for a prolonged period, the baby may suffer growth restriction in utero, or a premature birth and all the complications that can come with that.