Beyond Morning Sickness
By Anne Cavicchi

Typically, 3 out of 4 women will experience some degree of morning sickness with pregnancy. For a small percentage of these women, their "morning sickness" is far from just a normal part of pregnancy. If your morning sickness is severe, you may be one of the unfortunate sufferers of Hyperemesis Gravidarum.

What is Hyperemesis Gravidarum?
Hyperemesis Gravidarum (HG) is a very severe form of morning sickness. It is described as extreme vomiting, dehydration, nutritional deficiencies, and electrolyte imbalances combined with a first trimester weight loss of aproximately 10% of your normal body weight.

Most affected women have numerous episodes of vomiting throughout the day with few if any symptom-free periods, especially during the first three months. This can lead to hospitalization. Although usually resolved by 21 weeks, it often lasts the entire pregnancy.

What Casues HG?
There are numerous theories regarding the etiology of HG, however, none are conclusive as of yet. The most commonly held belief is that the increase in HCG and estrogen hormones in early pregnancy is the cause.

So, if I have extreme morning sickness, I have HG?
Not necessarily. Extreme nausea and vomiting in pregnancy may indicate other potentially serious disorders including:

• hydatidiform mole, which is an abnormal tumorous growth of the placenta
• multiple pregnancy (twins, etc.)
• viral gastroenteritis
• flu
• food poisoning
• hepatitis A
• hepatitis B
• hepatitis C
• urinary tract infection
• appendicitis
• cholecystitis, which is an inflammation of the gallbladder
• ulcers

It is important to visit your doctor for diagnosis.

How is it Diagnosed?
Diagnosis is based on a history of the woman's symptoms and a physical exam. Lab tests are also done to look for indications of dehydration and electrolyte imbalances. Signs may include:

• low blood pressure
• rapid pulse
• ketones, or the breakdown of fat in the urine
• increased blood count, or hematocrit
• low potassium level in blood
• low urine output
• highly concentrated urine

Tests that may help to rule out other disorders include:

• serum for hepatitis testing
• liver function tests
• ultrasound to look at gallbladder
• urinalysis and culture to test for bacteria
• ultrasound to look for twins or a tumorous growth of the placenta

Can it be Prevented?
Unfortunately, there is no known prevention -- only treatment.

Will HG harm my baby?
Some studies show that some women who have HG will have low birthweight babies. However, the good news is that most women with HG do have healthy babies.

Proper medical supervision is essential. If HG is left untreated, the mother may become so metabolically imbalanced that abortion is recommended to save the life of the mother. However, it should be considered only a last resort.

What are the long-term effects of the condition?
Properly treated, HG generally does not present serious long-term problems for the mother or infant.

How is it treated?
Treatments vary from diet modification, medicines, vitamins and herbs to homeopathy, accupressure, and chiropractic. Discuss your best options with your doctor.

This article is just a brief overview. If you think you may be suffering from Hyperemesis Gravidarum, please consult your doctor as soon as possible.