Emesis or hyperemesis gravidarum?
Between 50 and 80 percent of all pregnant women suffer from nausea and vomiting (emesis gravidarum) – mainly in the first twelve weeks of pregnancy. Some women even have to endure the condition beyond the 20th week of pregnancy. However, even if the unpleasant side effects are perceived as annoying and severely impair quality of life, they are not a sign of illness.
The situation is different with hyperemesis gravidarum, which occurs in 0.3 to 3 percent of all pregnant women. In this case, the nausea is accompanied by severe vomiting several times a day. To be more precise, doctors define hyperemesis gravidarum as when vomiting occurs more than ten times a day, when women are unable to keep food or drink down and lose more than five percent of their body weight.
Hyperemesis gravidarum usually begins between the 6th and 8th week of pregnancy, peaks around the 12th week of pregnancy and subsides around the 20th week of pregnancy. It is one of the most common reasons for hospitalization in the first half of pregnancy.
Hyperemesis gravidarum: consequences for the mother
Further consequences for the mother can be
- Weight loss of more than five percent
- Lack of water (dehydration)
- Electrolyte disturbances
- Lack of vitamins, fats, minerals, sugar, etc.
- Increase in blood acids (ketosis)
As a result of these deficiencies, anemia, thrombosis, nerve and brain diseases (Wernicke’s encephalopathy) can occur. Damage to the oesophagus due to frequent vomiting is also possible. A connection between hyperemesis gravidarum on the one hand and sleep disorders, anxiety and depression on the other has also been proven.
Hyperemesis gravidarum: consequences for the child
Hyperemesis gravidarum can also have serious consequences for the unborn child:
- Premature birth (before the 37th week of pregnancy)
- Reduced birth weight (less than 2.5 kilograms)
- Reduced size
However, hyperemesis gravidarum does not appear to cause spontaneous abortion (birth before the 20th week of pregnancy) or fetal death in the womb.
Risk factors for hyperemesis gravidarum
The bacterium Helicobacter pylori (H. pylori) could also play a role. The stomach germ is significantly more common in some pregnant women with hyperemesis gravidarum than in expectant mothers without severe pregnancy vomiting. However, it is not known whether the bacterium is the cause or consequence of hyperemesis gravidarum.
Other risk factors may be young age, the first pregnancy or multiple pregnancies. Body mass index, smoking or the economic background of the expectant mother do not appear to be significant.
Diagnosis via exclusion procedure
Severe nausea, severe vomiting or a weight loss of more than five percent during pregnancy does not necessarily indicate hyperemesis gravidarum. Doctors first try to clarify whether another illness may be causing the symptoms. These include, for example, gastrointestinal diseases (such as infections, gastritis, pancreatitis), neurological causes (such as migraines), urogenital diseases (such as urinary tract infections), metabolic diseases (such as increased calcium levels in the blood) or psychological disorders (such as eating disorders). A so-called molar pregnancy (bladder mole) – a rare malformation of the placenta – can also trigger hyperemesis gravidarum.
Treatment of hyperemesis gravidarum
In the case of hyperemesis gravidarum, lifestyle changes, complementary therapies and medication can alleviate the symptoms.
Lifestyle changes
Occasionally, it helps affected pregnant women to change certain habits in their lives. For example, small but frequent meals, eating cookies before getting up in the morning and plenty of rest can sometimes alleviate severe morning sickness and constant nausea. Avoid fatty or spicy foods and nausea-inducing smells or situations.
Complementary methods
A number of complementary methods appear to be effective for hyperemesis gravidarum. Acupressure, acupuncture, electrostimulation, autogenic training, massages and homeopathic remedies (Nux vomica, Pulsatilla) may alleviate the symptoms. The medicinal plants ginger, camomile and peppermint can also help against nausea and vomiting.
Complementary methods have their limits. If the symptoms persist over a longer period of time and do not improve or even get worse, you should always consult a doctor!
Medication
When to go to the clinic?
If you are suffering from hyperemesis gravidarum, are weak and have lost a significant amount of weight, do not hesitate to contact your doctor. Because before you or your child run the risk of being harmed, it is clearly more sensible to go to hospital. There you can be helped to prevent the possible consequences of hyperemesis gravidarum by means of artificial feeding (by infusion or feeding tubes).
