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Hyperemesis Gravidarum: When Pregnancy Nausea Is More Than Morning Sickness - Verily
Dr. Monique Ruberu walks us through what it’s like to be part of the 3 percent.

When it comes to taking care of your health, asking questions never hurts. But is it always worth a visit to your doctor? We’re asking experts to weigh in on your burning questions—from feminine to general health and everything in between—so you can get advice from a pro before you go. The doctor will see you now.

Imagine this scenario. You just found out that you are pregnant. The stick showed two lines, and you’re bursting with joy and anticipation. You prepare to tell the most important people in your life about this incredible blessing when, suddenly, you start to feel a little strange. Is it something you ate? Is this a bug? 

Nausea and vomiting in pregnancy are very common. This is often called “morning sickness” although it can occur at any time of the day. These symptoms generally start before 9 weeks of pregnancy and resolve by 14 weeks. Typical patients experience nausea for a short time each day and vomiting once or twice a day. Sadly, for some women, it lasts longer, possibly throughout the entire pregnancy, and is much more severe.

In some cases, the mom may have nausea that lasts several hours a day and vomiting occurs more frequently. The most severe form of nausea and vomiting is Hyperemesis Gravidarum, which occurs in about 3 percent of pregnancies. The diagnosis is based on weight loss and problems related to dehydration. If a mom has lost 5 percent or more of her pre-pregnancy weight because of nausea and vomiting and has become dehydrated, she likely has hyperemesis.

As with her first two pregnancies, Duchess Catherine Middleton is experiencing these symptoms during her third pregnancy—in fact, she was so ill that she missed dropping King George off on his first day of school this September. "When she was first pregnant with George in 2012, the young mom was hospitalized at King Edward II Hospital with what was reported to be 'a severe bout of morning sickness',” Vanity Fair reports. This time around, it seems her luck has not improved. Royal or not, Dr. Monique Ruberu proved to Verily that this pregnancy plight is no easy feat.

Who is at risk for hyperemesis gravidarum?

Hyperemesis often affects people who have a twin or triplet pregnancy. If you had a past pregnancy affected by nausea and vomiting, you may have an increased chance of dealing with this. If your mother or sister had severe nausea and vomiting in pregnancy or if you have a history of motion sickness or migraines, it may increase your risk. Strangely, it more commonly affects women who are carrying female babies.

When could it be something else?

Sometimes, severe vomiting and nausea are caused by other medical problems such as viruses, thyroid or gallbladder disease, or food-related illnesses. These are often associated with other symptoms such as fevers, abdominal pain, or an enlarged thyroid.

Will it hurt the baby?

Mild nausea and vomiting don’t usually affect the baby. Yet, if the symptoms become severe, the lack of nutrition that results can lead to lower birth weights and problems with the mom’s thyroid, liver, and fluid balance.

How do you treat hyperemesis gravidarum?

Early treatment is often the best approach. If you can prevent the severe symptoms, the mom may not need to be hospitalized for IV fluids and nutrition. You can start with easy things: suck on an organic lollipop, eat cold fresh fruit, drink ginger tea made from fresh grated ginger, keep cereal or crackers to munch on, eat small frequent meals, use “sea bands” that press on acupuncture points on the wrist, and take your prenatal vitamin right before bed.

If you find that these early measures aren’t helping, you may need some medication prescribed by your Ob/Gyn. There are multiple medications that can be taken orally or rectally in some cases which may help to end your symptoms.

If these medications aren’t helping, then an ER visit is important. There, doctors can make sure your electrolytes are balanced, give you IV fluid hydration and IV anti-nausea medications to help you feel a lot better. In very severe situations, you may need a continuous home IV solution and anti-nausea medication or nutrition through an IV as well. The most important thing to remember is that there is help out there and this will get better.