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Morning Sickness and Hyperemesis Gravidarum

Morning Sickness and Hyperemesis Gravidarum

Nausea and vomiting in pregnancy is extremely common. It is commonly referred to as morning sickness, however the nausea and vomiting can occur at any time of day. Studies estimate that nausea and vomiting occurs in 50 to 90% of pregnancies. For the majority of cases morning sickness is not a serious condition and it doesn't place the mother or baby at risk.

The most severe form of nausea and vomiting in pregnancy is called Hyperemesis Gravidarum. This condition can place the mother and baby at risk because the nausea and vomiting prevent the mother from retaining and utilizing food and fluid.

Hyperemesis occurs in approximately 1% of pregnant women. It can start between four to six weeks of pregnancy. Symptoms usually improve from about 15 to 20 weeks but occasionally last the entire pregnancy.

Distinguishing between Morning Sickness and Hyperemesis Gravidarum

Morning Sickness

Hyperemesis Gravidarum

Nausea sometimes accompanied by vomiting

Nausea accompanied by severe vomiting

Nausea that subsides at 12 weeks or soon after

Nausea that does not subside

Vomiting that does not cause severe dehydration

Vomiting that causes severe dehydration – decrease in urine output

Vomiting that allows you to keep some food down

Vomiting that does not allow you to keep any food down causing electrolyte imbalance

 

Weight loss of 5% or more of pre-pregnancy weight

 

Headaches, confusion, fainting, jaundice

Reference: http://americanpregnancy.org/pregnancycomplications/hyperemesisgravidarum.html - 31.10.07

If you are diagnosed with Hyperemesis, a plan of care to promote a healthy outcome for you and your baby can be developed. It is important to receive treatment early to prevent complications.

Every woman and her pregnancy are different and therefore every treatment is also different. Mild cases of Hyperemesis can be simply controlled by a change in diet, rest and antacids.

The more severe cases often require hospitalisation where there is close monitoring of food/liquid intake and output. Careful re-hydration is provided through an intravenous drip.

DO NOT take any medications to solve this problem without first consulting your health care provider.

Here are some tips to relieving your symptoms:

Dietary Modification Suggestions

  • Do not hesitate to eat when you want to, even if you are craving foods that are not part of your regular diet
  • Eat frequent small meals every two – three hours
  • Speak to your healthcare provider about your symptoms and how they affect you. He or she may recommend a safe and effective medication to treat your nausea and/or vomiting and to prevent the progression of the condition
  • Eat dry crackers 15 minutes before getting out of bed in the morning
  • Do not skip meals needlessly
  • Drink fluids ½ hour before a meal or ½ hour after a meal. Avoid drinking during your meal
  • Drink about eight glasses of liquid during the day to avoid dehydration
  • Try eating cold food rather than hot food (cold foods have less odour)
  • Avoid spicy foods
  • Avoid foods high in fat
  • High protein snacks are helpful
  • Increase intake of carbonated beverages
  • Include herbal teas containing peppermint or ginger or other ginger-containing beverages
  • If odours bother you while cooking, try to improve ventilation in the kitchen area
  • If it is possible, get assistance in the preparation of your meal

Activity

  • Limit noise, light, odours, and stimulation from others
  • Nausea and vomiting may worsen when you get overtired. Try to increase resting periods and take more naps during the day.

Alternative treatments

While the severe vomiting associated with hyperemesis requires medical attention, milder conditions of nausea or vomiting may be reduced with deep breathing and relaxation exercise.

If you are considering Natural therapies you should always consult a qualified Natural Therapies practitioner. Some women have found natural therapies helpful.

Vitamin B6 and ginger products (crystalised ginger, ginger lollies, ginger ale, tea or raw ginger) are the non-drug products of choice. Talk to your pharmacist about the correct dose of Vitamin B6.

It is helpful to discuss your nutritional needs with a dietician.

Wristbands can be used on the acupressure points on the wrists (two finger breadths down from the 'pulse point' on the outside of the wrists). These can usually be purchased from a chemist as a treatment for motion sickness.

Some Aromatherapy oils can be used as long as they are also prescribed by a qualified practitioner.

Some people have also found regular acupuncture treatments reduce nausea and vomiting. However it is essential that the practitioner is qualified and experienced in the area of maternity.

If you are taking other medications please talk to your pharmacist/doctor or call the National Prescribing Service Medicines Line on 1300 888 763 before taking any new medications.

Contact your doctor if you have any of the following

  • Abdominal pain, bleeding, or cramping
  • Difficulty thinking or concentrating
  • Visual changes
  • Difficulty walking or talking
  • Extreme tiredness and very low energy
  • Shortness of breath
  • Dizziness and / or fainting
  • Moderate or severe headache and/or fever
  • Muscular weakness or severe cramping in legs
  • A dry mouth
  • Repeated dry retching and vomiting
  • Severe nausea that keeps you from eating and drinking
  • Passing urine in small amounts and less often than usual
  • Urine is dark yellow and smelly
  • Vomit is blood stained or yellow / green with bile
  • Weight loss of 1 kg or more in a week

If you require any further information and advice contact your obstetrician, GP or the Mater Private Hospital Redland on 07 3163 7444

References:
http://www.sosmorningsickness.org/faq.html

http://emedicine.com/med/topic1075.htm

http://www.hyperemesis.org/hyperemesis-gravidarum/

Milliman Care Guildlines 11th Edition 2007

Mater Private Hospital

Redland Telephone: 3163 7444

Copyright © 2010 Misericordiae Health Services Brisbane Limited ACN 096 708 922

Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: PI-CLN-450033
Last modified 09/8/2017.
Consumers were consulted in the development of this patient information.
Last consumer engagement date: 28/2/2015
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