Extreme Morning Sickness in Pregnancy: Why It Happens & How It's Treated

pregnant morning sickness

It's a classic movie scene. The woman finds herself running to the bathroom to throw up, and suddenly it dawns on her, "I'm pregnant." Indeed, morning sickness is one of the classic signs of pregnancy, and some 85 percent of pregnant women will feel nauseated and throw up in the first trimester. But that's not every mom's story. For 2 percent of expectant mothers, an extreme morning sickness called hyperemesis gravidarum sets in sometime before the ninth week of pregnancy.

They're not just a little nauseous. They can't keep anything down. They're losing weight. They're dehydrated. Their OB/GYN is throwing around words like "ketones in the urine" and "liver abnormalities."

Hyperemesis gravidarum, or HG as it's commonly called, is one of the most common causes of hospital admissions for pregnant women. And unlike a mom suffering from run-of-the-mill morning sickness, a woman with HG will have unrelenting nausea and vomiting with no other obvious cause.


"HG is really the extreme end of the spectrum in which symptoms may lead to dehydration, weight loss, and at times, hospitalization," explains Dr. Alyssa Dweck, an OB/GYN with the Mount Kisco Medical Group in Westchester County, New York. "Weight loss, ketones in the urine, electrolyte imbalance, thyroid and liver abnormalities may be present."

In other words: this is not your typical nausea that can be quelled by eating salty crackers.

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Why this happens to some women is unknown, although rapidly rising human chorionic gonadotropin (HCG) and estrogen levels are likely related, and according to Dweck, women with "multiple gestations" have an increased risk. Old wives' tales have linked this kind of extreme sickness to carrying girls, but Dweck said there have been no studies backing up this urban legend -- so don't expect this to be your early gender predictor.

Do expect it to send you to your doctor.

"Inability to tolerate any liquids, decreased urination, weakness, dizziness, and other signs of dehydration warrant prompt medical attention," Dweck warns. "Persistent nausea and vomiting is concerning, especially if anti-nausea medications are not helpful."

A doctor or midwife can check you for weight loss as well as electrolyte imbalance and ketones in the urine. If an HG diagnosis is made, treatment varies. In more severe cases, intravenous fluid rehydration is required, and some moms with HG are admitted to the hospital where they may be fed through the IV as well to replenish the nutrients their body has been rejecting.

Pregnant women with HG are often prescribed pyridoxine (vitamin B6) and/or anti-nausea drugs so they can return to regular eating and a regular routine.

If you want to go a more natural route, Dweck recommends ginger supplements and acupressure to the inside wrist pressure point. Some women can also manage the condition by avoiding triggering stimuli, rest, and eating small but frequent meals, but your OB/GYN or midwife can help you build a treatment plan that will work best for you.

By the second trimester, severe morning sickness symptoms tend to abate with most HG patients, although it varies from woman to woman.

And while all of this may sound uncomfortable, there is a bright spot to having a hyperemesis gravidarum diagnosis:

"There is minimal effect of vomiting on the developing fetus," Dweck says. "In contrast, the miscarriage rate is lower in those with HG."

So all that throwing up may just help your pregnancy after all!

Have you encountered hyperemesis gravidarum? What was your treatment plan?


Image via © iStock.com/ValuaVitaly

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