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May 20, 2024
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Hyperemesis gravidarum: when nausea is excessive in pregnancy

Nausea and vomiting are possibly the most common symptoms associated with pregnancy. But what about when they become excessive?

This is exactly the meaning of hyperemesis gravidarum. ??Hyper? means a lot and? emesis? means vomiting. Hyperemesis, therefore, is a problem that affects pregnant women in the first trimester of pregnancy and that translates the presence of nausea and vomiting uncontrollably ?, explains Luiz Fernando Leite, obstetrician of Santa Joana Hospital and Maternity.

Élvio Floresti, gynecologist and obstetrician graduated from the Paulista School of Medicine, with the title of specialist in Gynecology and Obstetrics by Febrasgo (Brazilian Federation of Gynecology and Obstetrics Associations) and specialist in colposcopy, comments that, among the initial modifications of a pregnancy, the Gastrointestinal system is the most affected. Emesis, ie vomiting and nausea are common and common to almost all pregnant women. We call pregnancy hyperemesis an accentuation of this condition, where the cravings and vomiting are very intense, causing symptoms such as severe weakness, hypotension, hypoglycemia and even require hospital interventions ?, he adds.

But, how to differentiate hyperemesis from nausea and vomiting considered common in pregnancy? Below you clarify this and other doubts on the topic.

After all, how to identify pregnancy hyperemesis?

Floresti explains that emesis or even hyperemesis begins from the sixth week of gestation and usually disappears around the 12th week. "Of course there are pregnant women in whom symptoms persist almost throughout pregnancy, but this varies in both duration and intensity", comments.

Read also: Pregnancy symptoms: Know the first signs and find out if you are pregnant

Symptoms of hyperemesis, according to Floresti, may include:

Intense vomiting, no improvement with conventional treatment
Intense malaise
Anemia
Hypoglycemia
Dehydration

According to Leite, when emesis culminates in more than three episodes of vomiting in a day, it becomes known as pregnancy hyperemesis, and this may lead to harm to the pregnant woman.

To differentiate hyperemesis from "normal sickness", according to Élvio Floresti, it is necessary to perform an analysis of the patient's clinical condition. "If, in addition to the report of severe malaise, laboratory tests indicate factors such as: anemia, hypoglycemia, dehydration, for example, can be considered a hyperemesis," he says.

Milk adds that the risks of pregnancy hyperemesis are: leading the pregnant woman to dehydration, loss of appetite and even weight loss.

Main causes and risk factors

Floresti explains that gestational hormones, such as human chorionic gonadotropins (HCG) and progesterone, are the main causes of hyperemesis. "Most of the time we do not find the risk factors in the primiparous, but people with more tense and obese gastric disorders are more likely to have a hyperemesis," he says.

Also read: 8 Things A Pregnant Woman Can Do

Still according to the gynecologist and obstetrician, other factors that may be related to this condition are:

Twin pregnancy;
Mother or sister with a history of hyperemesis;
Hyperemesis in previous pregnancy;
Suffering from migraines or feeling sick while riding a car, plane or boat;
Have a pre-existing liver disease or thyroid problems, among others.

It is worth stressing that this condition should be diagnosed and followed up by the pregnant woman's trusted doctor.

How to deal with hyperemesis gravidarum?

As main measures for the pregnant woman to deal with this condition as best as possible, Élvio Floresti highlights:

Good medical follow-up and adequate information are essential, because the pregnant woman can be very weak and worried about her own health and baby health, in the face of hyperemesis.
The recommendation is to maintain a light diet, but at small and regular intervals, eating a small amount of food, because fasting irritates the gastric mucosa more, making the hyperemesis worse.
Drug treatment should be continuous, even as symptoms improve.
When the vomiting is very intense, oral medication is not used, because the pill does not even take effect and, when it reaches the stomach, ends up being expelled with vomiting. Ideal in this case are sublingual, injectable or suppository options.
Psychological support is also important: having the company of someone you trust, such as your mother or husband, and staying at home are measures that can reduce the insecurity of the pregnant woman.

Luiz Fernando Leite adds: Before eating, the pregnant woman can try to drink some ice cold water with lemon. Another precaution is to chew some ginger and avoid very hot and seasoned foods. Drier foods such as toast and crackers are welcome in the diet. The biggest tip is "do not force anything", as this will lead to worsening symptoms ?, highlights.

Treatments for hyperemesis

Floresti points out that the treatment of emesis or hyperemesis is the same: usually based on sublingual, suppository and injectable antiemetics. "In cases of hyperemesis, sometimes intravenous hydration in the hospital environment is necessary, ruling out the appearance of hydroelectrolytic disorders, caused by dehydration and malaise," he says.

Read also: The importance of prenatal care for mother and baby

"In cases where the psychosomatic condition is very intense, diagnosed with depression or anxiety, it is necessary to associate the use of mild antidepressants with treatment," adds Floresti.

Milk reinforces that treatment to improve hyperemesis is usually a mix of intravenous hydration with antiemetic medications. "Often, making a sedative for the patient to remain in absolute rest is also indicated," he adds.

Hyperemesis gravidarum: what about the baby at risk?

"The baby is not affected at all, because its nutrition is directly linked to the maternal blood flow through the placenta", concludes the gynecologist and obstetrician Élvio Floresti.

It is worth stressing that nausea and vomiting in early pregnancy are normal physiological reactions. Should special care exist when the intensity and frequency of these symptoms are higher, thus characterizing pregnancy hyperemesis? that should be accompanied and treated by the gynecologist and obstetrician trusted by the pregnant woman.